HISTORY  AND   PATHOLOGY 


VACCINATION 


HISTORY    AND    PATHOLOGY 


OF 


VACCINATION 


VOL.     I. 

A    CRITICAL    INQUIRY 


EDGAR    M.    CROOKSHANK.    M.B. 

PROFESSOR     OF     COJMPARATIYE     PATHOLOGY     AND      BACTERIOLOGY      IN,    AND    FELLOW    OF, 
king's    college,    LONDON. 

AUTHOR     OF    PAPERS     ON    THE    ETIOLOGY    OF    SCARLET     FEVER;      ANTHRAX     IN     SWINE; 

TUBERCULOSIS     AND     THE     PUBLIC     MILK     SUPFLY  ;      AND    THE     HISTORY    AND 

PATHOLOGY   OF   ACTINOMYCOSIS  ;    IN    REPORTS  OF   THE    AGRICULTURAL 

DEPARTMENT   OF  THE    PRIVY  COUNCIL,   ETC. 

AUTHOR    OF    A    MANUAL    OF    BACTERIOLOGY,     ETC. 


PHILADELPHIA 
P.  BLAKISTON,  SON,  &:  CO.,   1012,  WALNUT  STREET 


Biomedical 
Library 


v./ 


PREFACE 


T  N   this    Preface    I   have  thought   it   necessary   to  lay 
^      before    the    profession,    the     circumstances    which 
have   led   to  the   production   of  these  volumes. 

I  had  devoted  myself  for  some  time  to  patho- 
logical researches  in  connection  with  the  communicable 
diseases  of  man  and  the  lower  animals,  when  the 
discovery  of  an  outbreak  of  Cow  Pox,  in  1887,  led 
me  to  investigate  the  history  and  pathology  of  this 
affection.  At  that  time  I  accepted  and  taught  the 
doctrines,  in  reference  to  this  disease,  which  are 
commonly  held  by  the  profession,  and  are  described 
in  the  text-books  of  medicine. 

In  endeavouring  to  discover  the  origin  of  this 
outbreak,  it  was  proved  beyond  question  that  the 
cows  had  not  been  infected  by  milkers  suffering 
from  Small  Pox.  This  fact,  together  with  the 
clinical  characters  of  the  disease  in  the  cows,  and  in 
the  milkers  infected  from  the  cows,  and  the  certainty, 
that  I  had  to  deal  ''not  with  an  infectious  disease 
like     cattle-plague     or     pleuro-pneumonia,     but    with     a 

676888 


vi  PREFA  CE. 

disease  which  is  communicated  solely  by  contact^'' 
convinced  me  that  the  commonly  accepted  descriptions 
of  the  nature  and  origin  of  Cow  Pox  were  purely 
theoretical.  As  the  natural  Cow  Pox  had  not  been 
investigated  in  this  country  for  nearly  half  a  century, 
it  was  obvious  that  a  much  neglected  field  of  compara- 
tive pathology  had  been  opened  up  for  further  inquiry. 

My  interest  in  this  subject  was  further  stimulated 
by  Sir  James  Paget,  who  very  kindly  examined  one 
of  the  milkers  casually  infected  from  the  cows,  and 
while  so  doing  drew  my  attention  to  a  copy  of  Dr. 
Creighton's  work  on  Cow  Pox  and  Vaccinal  Syphilis, 
then  just  published.  The  question  naturally  arose, 
whether  my  observations  supported  or  refuted  the 
conclusions  arrived  at  by  Dr.  Creighton  as  the  result 
of  his  historical  researches. 

While  attending  at  the  National  Vaccine  Establish- 
ment of  the  Local  Government  Board,  I  was  unable 
to  obtain  any  exact  details,  clinical  or  pathological, 
of  the  source  of  the  lymph  which  was  employed 
there.  From  my  experience  of  this  and  other 
vaccination  stations,  I  found  that  both  official  and 
unofficial  vaccinators  were  completely  occupied  with 
the  technique  of  vaccination,  to  the  exclusion  of 
any  precise  knowledge  of  the  history  and  pathology 
of  the  diseases  from  which  their  lymph  stocks  had 
been  obtained.  Thus,  at  this  early  stage  of  my 
investigation,    I    felt    that    what    Ceely    said,    in    1840, 


PREFA  CE.  vii 

was  still  true :  "  The  imperfect  knowledge  which  we 
at  present  possess  on  many  points  connected  with 
the  natural  history  of  the  variolce  vaccince,  and  the 
numerous  and  formidable  impediments  to  the  improve- 
ment and  extension  of  that  knowledo^e,  demand  the 
continuance  of  vigilant,  patient,   and  diligent  inquiry." 

In  January,  1888,  while  I  was  studying  the  litera- 
ture of  the  subject  at  the  Library  of  the  Royal 
College  of  Surgeons,  Mr.  Baily,  the  librarian,  to 
whom  I  am  indebted  for  much  courteous  assistance, 
was  engaged  in  re-cataloguing  the  Library.  He  found 
a  parcel  cf  MSS.,  which  he  thought  might  prove  of 
interest  to  me.  It  contained  letters  from  Hunter  to 
Jenner,  and  a  manuscript  which  was  thought  to  be 
the  MS.  of  Jenner's  Inquiry.  On  carefully  perusing 
it,  I  discovered  that  it  differed  in  many  respects  from 
the  published  Inquiry;  it  was,  in  fact,  Jenner s 
Communication  to  the  Royal  Society.  I  was  so 
struck  by  the  contents  of  this  paper,  and  the  small 
amount  of  evidence  upon  which  Jenner  had  first 
ventured  to  propose  the  substitution  ot  Cow  Pox 
inoculation  or  vaccination  for  the  old  system  of  Small 
Pox  inoculation  or  variolation^  that  I  was  induced  to 
carefully  look  into  the  life  of  Jenner  and  the  early 
history  of  vaccination,  as  contained  in  Baron's  Bio- 
graphy, and  in  the  correspondence  and  articles  on 
the  subject  in  contemporary  medical  and  scientific 
periodicals 


viii  PREFA  CE. 

Now  that  the  value  of  Jenner's  MS.  and  the  interest 
attached  thereto,  have  been  pointed  out,  it  has  been 
carefully  preserved,  and  entered  in  the  catalogue  of  the 
Library,  and  may  be  consulted  by  any  one  desiring 
to  do  so.  From  a  letter,  dated  1877,  which  will  be 
found  in  the  parcel,  it  will  be  seen  that  Hunter's  letters 
and  Jenner's  MS.  were  given  to  Sir  James  Paget, 
by  a  lady  into  whose  possession  they  had  passed 
on  the  death  and  by  the  will  of  her  cousin,  the 
late  Colonel  Jenner,  son  of  Dr.  Jenner.  On  June 
4th,  1879,  Sir  James  Paget  wrote  to  Mr.  [now  Sir 
John]  Simon,  President  of  the  College,  presenting 
the  MSS.  to  the  Library  of  the  College.  The 
MSS.  appear  to  have  remained  in  a  drawer  until  they 
were  brought  to  light  under  the  circumstances  which 
I   have  just  related. 

I  gradually  became  so  deeply  impressed  with  the 
small  amount  of  knowledge  possessed  by  practitioners, 
concerning  Cow  Pox  and  other  sources  of  vaccine 
lymph,  and  with  the  conflicting  teachings  and  opinions 
of  leading  authorities,  in  both  the  medical  and 
veterinary  professions,  that  I  determined  to  investigate 
the  subject  for  myself  From  antiquarian  booksellers 
in  Paris,  Berlin,  and  in  this  country,  I  succeeded  in  a 
very  short  time  in  obtaining  a  large  number  of  works 
dealing    with    the    early    history    of  vaccination. 

They  at  the  same  time  forwarded  many  works  on 
Small     Pox     inoculation,     and     thus     niy     interest     was 


PREFACE.  ix 

aroused  in  this  subject  also,  and  its  bearing-  upon  the 
history  and  pathology  of  vaccination  was  soon  apparent. 

In  February.  1888.  I  resolved  to  consult  the  leadinp; 
authorities  in  France,  and  to  obtain,  if  possible,  the 
history  both  of  the  Bordeaux  Lymph,  and  of  the 
outbreaks  of  Cow  Pox  which  had  been  met  with  in 
that  country  during  the  time  that  the  disease  was 
supposed   to  be   extinct   in   this. 

I  take  this  opportunity  of  thanking  M.  Hervieux  for 
much  information,  and  for  his  kindness  in  aftbrding 
me  opportunities  for  observing  the  system  of  public 
vaccination  in   Paris. 

To  M.  Cagny,  I  cannot  sufficiently  express  my 
indebtedness  both  for  introductions  to  his  colleao-ues, 
and  for  presenting  me  with  a  copy  of  the  work  of 
Auzias  -  Turenne  containing  his  classical  essays  on 
Cow    Pox  and    Horse   Pox. 

From  Paris,  I  proceeded  to  Bordeaux  where  Dr.  Layet 
and  M.  Baillet  received  me  with  the  greatest  courtesy, 
and  afforded  me  every  opportunity  of  obtaining  infor- 
mation concerning  the  Municipal  Vaccination  Service  ; 
and  we  discussed  the  details  of  the  recent  outbreaks 
of  Cow  Pox  which  they  had  observed.  I  also 
succeeded  in  obtaining,  through  the  kindness  of  Dr: 
Dubreuilh.  a  full  account  of  the  "  spontaneous "  out- 
break    which     was     the     source     of    a     recent     official  ^ 

'  Kcpurf  of  the  Medical   Officer  of  the  Local  Government  Board. 
1882.     p.  iv. 

VOL.   I.  0 


X  PREFA  CE. 

Stock  of  vaccine  lymph  now  employed  in  this  country, 
though  abandoned  at  the  Animal  Vaccine  Station  at 
Bordeaux.^  At  Toulouse,  at  the  Veterinary  School,  I 
was  able  to  obtain  further  information  about  the  nature, 
clinical  characters,  and  origin  of  Cow  Pox  and  Horse 
Pox.  M.  Peuch,  the  distinguished  Professor  of  Veteri- 
nary Pathology,  furnished  me  with  the  details  of  his 
remarkable  investigations  into  Horse  Pox,  and  has 
since  granted  me  permission  to  reproduce  the  coloured 
plates  illustrating  this  subject.  M.  Peuch 's  researches 
and  observations  will  be  of  the  greatest  value  in 
bringing  to  light  a  disease  of  the  horse  which  is 
still  unrecognised  by  practical  veterinarians  in  this 
country. 

I  also  had  the  opportunity  of  studying  the  clinical 
characters,  and  the  results  of  inoculation  of  Sheep 
Pox. 

At  jMontpellier,  I  visited  the  Vaccine  Establishment 
of  M.  Pourquier,  and  obtained  from  him  some  in- 
teresting information.  On  returning  to  Paris,  I  was 
most  kindly  received  by  M.  Chauveau,  who  discussed 
with  me  the  affinities  of  Cow  Pox,  and  showed  me  the 
beautiful  and  valuable  drawings  which  had  been  pre- 
pared for  the  Report  of  the  Lyons  Commission,  but 
unfortunately  had  been  withheld  from  publication 
owing  to  the  expense  that  would  have  been  entailed. 


British  Mofical  Joitnial.     July  i4tli,  1888. 


PREFA  CE.  xi 

On  returning  to  England,  I  renewed  my  investi- 
gations in  Gloucestershire,  Wiltshire,  and  Dorsetshire. 
I  obtained  additional  information  with  reference  to 
cases  of  Cow  Pox  in  this  country,  and  fully  realised 
that  the  belief  that  this  disease  is  extinct  in  Enofland 
has  resulted  from  the  determined  and  often  successful 
attempts  which  are  made  by  farmers  (for  obvious 
reasons)  to  conceal  outbreaks  when  they  occur. 
I  also  followed  up  the  history  of  Mr.  Jesty, 
by  visiting  Worth  Matravers  in  the  Isle  of 
Purbeck,  and  obtaining  all  the  local  information 
possible. 

Lastly,  for  reference  to  some  works,  copies  of 
which  I  have  not  hitherto  succeeded  in  obtaining, 
I  have  availed  myself  of  the  British  Museum  and  our 
medical  libraries. 

The  difficulty  in  gaining  access  to  these  works  is 
no  doubt  the  reason  why  the  originals  have  been  so 
little  read.  It  would  hardly  be  possible  for  the 
practitioner  with  but  little  time  at  his  disposal,  and, 
if  in  the  country,  without  access  to  many  medical 
libraries,  to  undertake  such  an  inquiry  ;  iDut  I  trust 
that  the  system  which  has  been  followed  in  this 
work  of  giving  copious  extracts  will  induce  others  to 
study  the  original  authorities.  All  the  selections 
from  Jenner's  correspondence  have  been  drawn  from 
P)aron's  Biography,  with  the  exception  of  one  letter, 
which    was    obtained     for    me    by    Mr.    W.     K.     Dale. 


xii  PREFA  CE. 

I  desire  to  thank  him  ;  and  also  the  owner  for 
permission  to  reproduce  it  in  fac-simile.  The  essays 
composing  the  second  volume  have  been  reprinted 
with  the  object  of  affording  references  in  a  handy 
form. 

My  best  thanks  are  due  to  Mr.  James  Ceely 
for  approving  of  the  proposal  to  reprint  his  brother's 
classical  papers,  and  to  Mr.  Badcock  for  granting  me 
permission   to   reprint   his   pamphlet. 

In  conclusion,  I  desire  to  thank  Messrs.  W.  K.  Dale 
and  E.  F.  Herroun  for  their  assistance  in  passing 
the  proof  sheets  through  the  press.  Messrs.  Vincent, 
Brooks,  Day,  &  Son  are  to  be  congratulated  upon 
the  success  with  which  they  have  reproduced  the 
coloured    plates, 

Edgar  M.  Crooks  hank. 

24,  Manchester  Square,  W., 
April  1889. 


CONTENTS     OF     VOL.     I. 


CHAPTER    I. 

PAGE 
HISTORY    OF    SMALL    POX    INOCULATION    IN    FOREIGN    COUNTRIES  .  .  1 


CHAPTER    n. 

HISTORY    OF    INOCULATION    IN    GREAT    BRITAIN    AND    IRELAND         .  .  24 

CHAPTER    in. 

THE    OPER^VTION    OF    INOCULATION     .  .  .  .  .  .  .52 

CHAPTER    IV. 

HAYGARTH's    system    FOR    PREVENTING    SMALL    POX    .  .  .  .  81 

CHAPTER   V. 

THE    TRADITIONS    OF    THE    D.AIRYMAIDS       ...  .  .  98 

CHAPTER   VI. 

LIFE    AND    LETTERS    OK    EDWARD    JENNER  .....        I25 

CHAPTER   VII. 

JENNER's    REJECTED     "  INQUIRY  "......-        25O 


xiv  CONTEXTS. 

CHAPTER  VIII. 

IENXEr's    published    "  INQUIRY  "    . 


CHAPTER   XVI. 
ruooRi:ss  ok  vaccination  in  England 


PAGE 
266 


CHAPTER    IX. 

HUM.A.N    SMALL    POX    AS    A    SOURCE    OF     "  VACCINE    LYMPH  "  .  .       287 

CHAPTER   X. 

CATTLE    PLAGUE    AS    A    SOURCE    OF     "  VACCINE    LYMPH  "        .  .  .       307 

CHAPTER   XI. 

SHEEP  SMALL  POX  AS  A  SOURCE  OF  "  VACCINE  LYMPH  "      .      .   329 

CHAPTER  XII. 

GOAT  POX  AS  A  SOURCE  OF  '"VACCINE  LYMPH  "    ....   337 

CHAPTER   XIII. 

COW    POX    AS    A    SOURCE    OF     "  VACCINE    LYMPH  "         .  .  .  .       34O 

CHAPTER   XIV. 

"grease"  as  a  SOURCE  OF  "  VACCINE  LYMPH  "   ....   372 

CHAPTER   XV. 

INTRODUCTION    OF    VACCINATION    IN    FOREIGN    COUNTRIES     .  .  •       419 


430 


LIST    OF   PLATES 


Plate  I.     PORTRAIT    OF   Mr.  BENJAMIN    JESTY        facing  title  page 

Reduced  fac -simile  of  an  engraving  b}'  W.  Saj-,  from  the  original 
painting  by  M.  W.  Sharp. 

The  engraving  bears  the  following  inscription  : — 

"  To  the  President,  Vice-Presidents,  Treasurers,  Trustees,  and  Medical 
Officers  of  the  Original  Vaccine  Institution. 

"This  print  of  Mr.  Benjamin  Jestj-,  from  a  picture  in  the  possession 
of  the  Institution,  is  respectfullj'  inscribed  by  their  devoted  Servant, 
Will'"-  Say. 

"  Mr.  B.  JESTV,  Farmer  of  Downshay,  Isle  of  Purbeck,  set.  70,  who 
inoculated  his  Wife  and  Two  Sons  for  the  Vaccine  Pock  in  1774,  from 
his  cows,  at  that  Time  disorder'd  by  the  Cow  Pock,  and  who  subse- 
quently from  the  most  rigorous  Trials  have  been  found  unsusceptible  of 
the  Small  Pox.  Having  rationally-  set  the  Example  of  Vaccine  Inoculation 
from  his  own  knowledge  of  the  Fact  of  Unsusceptibilit\-  of  the  Small  Pox 
after  casual  Cow  Pock  in  his  own  Person  and  in  that  of  others,  and  from 
knowing  the  harmlessness  of  the  Complaint.  To  commemorate  the  Author 
of  these  historical  truths  the  Vaccine  Institution  have  procured  this 
portrait."  (Extract  from  the  Minutes  of  the  Original  Vaccine  Institution, 
Broad  .Street,  Golden  Square.) 


Plate  II.     NATURAL   COW  POX.     Case  of  Sarali   Nelmes,  Dairy- 
maid.     iJENNER) facing  p.     136 

"SARAH  NELMES,  a  dairymaid  at  a  Farmer's  near  this  place 
[Berkelej'J,  was  infected  with  the  Cow  Pox  from  her  master's  cows  in  Maj' 
1796.  She  received  the  infection  on  a  part  of  the  hand  which  had  been 
previously  in  a  slight  degree  injured  by  a  scratch  from  a  thorn.  A  large 
pustulous  sore  and  the  usual  sj'mptoms  accompanj'ing  the  disease  were 
produced  in  consequence.  The  pustule  was  so  expressive  of  the  true 
character  of  the  Cow  Pox,  as  it  commonl}"  appears  upon  the  hand,  that 
I  have  given  a  representation  of  it  in  the  annexed  plate.  The  two  small 
pustules  on  the  wrists  arose  also  from  the  application  of  the  virus  to  some 
minute  abrasions  of  the  cuticle,  but  the  livid  tint,  if  the}'  ever  had  any, 
was  not  conspicuous  at  the  time  I  saw  the  patient.  The  pustule  on  the 
forefinger   shows  the  disease    in    an    earlier  stage.     It   did   not   actually 


LIST  OF  PL  A  TES. 


appear  on  the  hand  of  this  young  woman,  but  was  taken  from  that  of 
another,  and  is  annexed  for  the  purpose  of  representing  the  maladj'  after 
it  has  newly  appeared." — (Jeniier.') 


Plate  III.     INOCULATED  HORSE  POX.     Fatal  case  of  John  Baker. 

{JENNER) facing  p.     248 

"JOHN  BAKER,  a  child  of  five  years  old,  was  inoculated  March  i6th, 
1798,  with  matter  taken  from  a  pustule  on  the  hand  of  Thomas  Virgoe, 
one  of  the  servants  who  had  been  infected  from  the  mare's  heels.  He 
became  ill  on  the  6th  day  with  symptoms  similar  to  those  excited  by 
Cow  Pox  matter.     On  the  8th  day  he  was  free  from  indisposition. 

"  There  was  some  variation  in  the  appearance  of  the  pustule  on  the 
arm.  Although  it  somewhat  resembled  a  Small  Pox  pustule,  yet  its 
similitude  was  not  so  conspicuous  as  when  excited  by  matter  from  the 
nipple  of  the  cow,  or  when  the  matter  was  passed  from  thence  through 
the  medium  of  the  human  subject. 

"This  experiment  was  made  to  ascertain  the  progress  and  subsequent 
effects  of  the  disease  when  thus  propagated.  We  have  seen  that  the  virus 
from  tlie  horse,  when  it  proves  infectious  to  the  human  subject,  is  not  to 
be  relied  upon  as  rendering  the  system  secure  from  variolous  infection, 
but  that  the  matter  produced  by  it  upon  the  nipple  of  the  cow  is  perfectly 
so.  Whether  its  passing  from  the  horse  through  the  human  constitution, 
as  in  the  present  instance,  will  produce  a  similar  effect,  remains  to  be 
decided.  This  would  now  have  been  effected,  but  the  boy  was  rendered 
unfit  for  inoculation  from  having  felt  the  effects  of  a  contagious  fever  in  a 
workhouse,  soon  after  this  experiment  was  made." — {Jeitiicr.) 


Plate     IV.      SMALL    POX    AFTER    PERFECT    VACCINATION. 

{MONRO) facing  p.     i-ji 

This  plate  "  represents  large  vesicles  which  formed  on  the  cheek  of 
my  eldest  son  on  the  5th  day  of  the  eruption.  The  face  was  much 
swollen,  and  the  skin  of  a  deep  crimson  colour.  On  the  temple  there  is  a 
large  pustule,  which  has  all  the  genuine  characters  of  the  Small  Pox 
pustule.  The  depression  in  the  centre  was  very  obvious;  and  between 
this  and  the  outer  angle  of  the  eye,  and  also  above  the  eye-brow,  there 
are  several  pimples  of  different  sizes  and  forms,  some  of  which  never 
passed  beyond  the  first  or  inflammatory  stage.""—  {Monro.) 


Plate  V.     INOCULATED  HORSE  POX,  AFTER  TRANSMISSION 
THROUGH  THE  COW.     Case  of  William  Pead.     {JENNER) 

facing  p.     274 

"Here  my  researches  were  interuipted  till  the  spring  of  the  year  1798, 
when  from  the  wetness  of  the  early  part  of  the  season,  many  of  the  farmers" 
horses  in  this  neighbourhood  were  affected  with  sore  heels,  in  consequence 
of    whicit    the    ("ow-pox    broke  out  among  several  of  our  dairies,   which 


LIS!    OF  FLA  TFS. 


afforded  me  an  opportunity  of  making  further  observations  upon  this 
curious  disease. 

''A  mare,  the  property  of  a  person  who  keeps  a  dairy  in  a  neighbouring 
parish,  began  to  have  sore  heels  the  latter  end  of  the  month  of  February 
1798,  which  were  occasional!}'  washed  by  the  servant  men  of  the  farm, 
Thomas  Virgoe,  William  Wherret,  and  William  Haynes,  who  in  con- 
sequence became  affected  with  sores  in  their  hands,  followed  by  inflamed 
lymphatic  glands  in  the  arms  and  axillse,  shiverings  succeeded  by  heat, 
lassitude  and  general  pains  in  the  limbs.  A  single  paroxysm  terminated 
the  disease  ;  for  within  twenty-fonr  hours  they  were  free  from  general 
indisposition,  nothing  remaining  but  the  sores  on  their  hands. 

"  William  Summers,  a  child  of  five  years  and  a  half  old,  was  inoculated 
the  same  day  with  Baker  [see  description  of  Plate  III.,  E.  M.  C],  with 
matter  taken  from  the  nipples  of  one  of  the  infected  cows,  at  the  farm 
alluded  to.  He  became  indisposed  on  the  6th  daj',  vomited  once,  and  felt 
the  usual  slight  symptoms  till  the  8th  day,  when  he  appeared  perfectly 
well.  The  progress  of  the  pustule,  formed  by  the  infection  of  the  virus, 
was  similar  to  that  noticed  in  Case  XV^II.  [James  Phipps,  E.  M.  C],  with 
this  exception,  its  being  free  from  the  livid  tint  observed  in  that  instance. 

"  From  William  Summers  the  disease  was  transferred  to  WILLIAM 
PEAD,  a  boy  of  eight  years  old,  who  was  inoculated  March  28th.  On  the 
6th  day  he  complained  of  pain  in  the  axilla,  and  on  the  7th  was  aftected 
with  the  common  symptoms  of  a  patient  sickening  with  the  Small-pox 
from  inoculation,  which  did  not  terminate,  till  the  3rd  day  after  the  seizure. 
So  perfect  was  the  similarity  to  the  variolous  fever  that  I  was  induced  to 
examine  the  skin,  conceiving  there  might  have  been  some  eruptions,  but 
none  appeared.  The  efflorescent  blush  around  the  part  punctured  in  the 
boy's  arm  was  so  truly  characteristic  of  that  which  appears  on  variolous 
inoculation,  that  I  have  given  a  representation  of  it.  The  drawing  was 
made  when  the  pustule  was  beginning  to  die  away,  find  the  areola  retiring 
from  the  centre." — {Jcniter.) 

Plate  VI.     INOCULATED  HORSE  POX,  AFTER  TRANSMISSION 
THROUGH  THE  COW.     Case  of  Hannah  Excell.     (JENNER) 

following  Plate   V. 

"  April  5th.  Several  children  and  adults  were  inoculated  from  the  arm 
of  William  Pead  [see  description  of  Plate  V.]. 

"  HANNAH  EXCELL,  an  healthy  girl  of  seven  years  old,  and  one  of  the 
patients  above  mentioned,  received  the  infection  from  the  insertion  of 
the  virus  under  the  cuticle  of  the  arm  in  three  distinct  points.  .  The 
pustules  which  arose  in  consequence  so  much  resembled,  on  the  I2thday, 
those  appearing  from  the  insertion  of  variolous  matter,  that  an  experienced 
Inoculator  would  scarcely  have  discovered  a  shade  of  difference  at  that 
period.  Experience  now  tells  me  that  almost  the  only  variation  which 
follows  consists  in  the  pustulous  fluid  remaining  limpid  nearly  to  the  time 
of  its  total  disappearance,  and  not  as  in  the  direct  Small-pox  becoming 
purulent." — (Jciiiicr. ) 

Plate     VH.     INOCULATED     COW     POX     AND     INOCULATED 

SMALLPOX.     {BALLHORN  AND  STROMEYER)  facing  p.     2S8 

This  plate  was  produced  by  Ballhorn  and  Stromeyer.  Traile  de 
riiioailafioti  vaccine,  1801.      [It  illustrates  the  results  of  cultivated  vaccine 


LIST  OF  PLATES. 


and  the  ordinary  results  of  a  direct  inoculation  of  Small-pox.  In  this 
case  the  appearances  are  strikingly  dissimilar,  but  Adams  selected  a  mild 
variety  of  Small-pox,  called  the  pearl  sort,  and  succeeded  by  cultivation  on 
the  human  subject  in  producing  appearances  indistinguishable  from 
ordinary  vaccination. — E.M.C.] 


Plate  VIII.     VARIOLATION  OF  THE  COW.     {CEELY)  facing  p.     298 

Showing  the  progress  of  the  variolation  experiment  on  the  fifteenth 
day. 

"The  variolous  vesicle  at  its  maximum  of  development  with  a  large 
central  crust ;  it  had  a  florid  glistening  appearance.  The  vaccine  vesicles 
of  the  seventh  day  were  also  at  their  greatest  development,  had  slight 
central  crust,  and  were  surrounded,  like  the  variolous  vesicle,  with  a  small 
pale  areola." — {Ceely.) 

The  whole  histor}'  of  this  experiment  is  as  follows  : — 

"  E.xpcriiiiciit  first. — Red  and  white  sturk,  thin  skin,  gentle,  well  bred  : — 
Made  seven  punctures,  and  introduced  fourteen  points,  charged  half  their 
length,  near  the  left  side  of  the  vulva  and  below  it.     Inserted  two  setons, 
charged  with  Small-pox  virus  from  the  same  subject,  at  the  same  time. 

"Fifth  Day. — Two  or  three  of  the  punctures  tumid,  all  closed  with 
brown  plugs  ;  setons  tumid. 

"  S/xt/i  Day. — Some  pimctures  tumid. 

"Seventh  Day.— Less  tumid. 

"  Eight/i  Day. — Still  less  so  ;  setons  passive,  dry,  adherent. 

"  Ninth  Day. — No  material  alteration,  and  therefore  vaccinated  on  the 
right  side  of  the  vulva,  in  seven  punctures,  with  fifth,  sixth,  and  seventh 
daj-  lymph,  on  fourteen  points,  from  a  young  child  ;  &\\d. below  the  vulva,  in 
four  punctures,  with  eight  points. 

"  Tenth  day  of  variolation,  A-eco;/c/ of  vaccination  :  Some  of  the  variolated 
punctures  hard  and  elevated ;  but  one,  near  the  margin  of  the  vulva,  has 
assumed  the  form  and  appearance  of  the  vaccine  vesicle ;  it  is  nearly 
circular,  has  an  elevated  margin,  and  a  small  crust  in  the  depressed  centre. 
By  gently  removing  the  central  irregular  crust,  and  careful|ly  puncturing 
the  cuticle  from  under  which  this  appears  to  have  exuded,  Ij'mph  was 
obtained,  and  thirty-eight  points  were  scantily  charged  in  the  course  of  an 
hour.     Vaccinated  punctures  on  the  right  side,  rather  red  and  elevated. 

"Eleventh  day  oJ  variolation,  third  day  of  vaccination:  The  circular 
indurated  intumescence,  forming  the  margin  of  the  vesicle,  somewhat 
flattened  and  diminished.  Vaccine  punctures  more  red,  larger,  and  more 
elevated.  Evening:  more  crust  in  the  centre  of  the  Small-pox  vesicle; 
margin  less  elevated.     Vaccine  vesicles  advancing. 

"  Twelfth  day  of  variolation,  fourtli  day  of  vaccination  :  Margin  of  the 
Small-pox  vesicle  more  elevated  and  red;  central  crust  darker;  two  of  the 
other  variolous  punctures  more  tumid,  but  without  lymph,  still  merelj' 
tubercular.     Vaccinated  punctures  more  tumid  and  inflamed. 

"  Thirteenth  day  of  variolation,  fifth  day  of  vaccination  :  Small-pox 
vesicle  more  inflamed,  nearly  as  florid  as  the  mucous  membrane  of  the 
vulva,  which  has  lately  assumed  a  bright  rose  colour.  Every  puncture 
made  for  tiic  vaccine  lymph  (five  days  since)  effectual,  vesicles  of  different 
forms  and  sizes  being  now  apparent.     Charged  some  points  from  them. 

"  l''viirtcentli  day  of  variolation,  sixth  ol'  vaccination  :  .Small-pox  vesicle 


LIST  OF  PL  A  TES.  xix 

has  less  marginal  induration,  seems  flatter,  and  crust  partially  loosened. 
Vaccine  vesicles,  some  partly  subsiding,  some  a  little  pustular,  others  still 
red,  and  all  surrounded  by  indurated  borders. 

*'  Fifteenth  day  of  variolation,  seventh  of  vaccination  :  Small-pox  vesicle 
enlarging;  crust  larger;  indurated  elevated  margin  of  the  vesicle  quite 
circular,  red,  and  glistening  towards  the  centre.  Vaccine  vesicles  larger 
and  more  elevated.     Took  from  them  more  lymph. 

"  Sixteenth  Hoy  of  variolation,  eighth  of  vaccination  :  Small-pox  vesicle 
diminished  ;  crust  increased  and  loosening.  Vaccine  vesicles  also  dimin- 
ished, some  rather  pustular ;  crusts  brown  and  pale  j-ellow,  some  crusts 
abraded  partiallj',  others  loose. 

"Seventeenth  r/rtj' of  variolation,  ;///////  of  vaccination  :  Small-pox  vesicle 
has  scarcely  an}"  redness  on  its  border  ;  crust  remaining.  Vaccine  vesicles 
diminishing,  and  covered  with  blackish  brown  crusts  within  their  circular 
or  oval  margins,  which  are  much  flattened. 

"  Eighteenth  day  of  variolation,  tenth  of  vaccination  :  Small-pox  vesicle 
very  much  flattened.  Vaccine  vesicles  equallj^  so,  covered  with  black 
crusts  of  different   sizes. 

"  Twenty-fiftli  day  of  variolation,  seventeenth  of  vaccination  :  Scar  of 
Small-po.K  vesicle  apparent ;  it  is  deep,  wrinkled,  and  of  a  pale  rose  colour. 
Scars  of  the  vaccine  vesicles  differ  only  in  being  smaller,  less  deep,  and 
have  more  induration  around  them."' — {Ceely.) 

Plate  IX.     NATURAL  COW  POX.     (CEELY)    .         .         facing  p.     348 

"  Fig.  I  e-Khibits  the  disease  at  the  end  of  the  second  w^eek.  It  shows 
vesicles  with  central  crusts,  acuminated  vesicles,  imperfectly  desiccated 
vesicles,  and  vesicles  further  advanced  in  desiccation.  Tlie  teat  raw  and 
swollen  from  the  injuries  sustained  during  milking. 

"Fig.  2.  The  teat  of  a  cow,  with  a  fairer  skin,  exhibiting  perfect 
cicatrices,  cicatrices  with  secondary  crusts,  raw  and  imperfect  cicatrices, 
and  a  crust  still  adherent  on  the  base  of  the  teat." — (Ceely.) 

Plate  X.     PHAGEDENIC    ULCERATION    IN    NATURAL    COW- 
POX.     (CROOKSHANK) facing  p.     350 

Reproduced  from  the  original  water-colour  drawing  of  a  case  from 
Wiltshire.  This  animal  had  been  selected  by  the  farm  bailiff  as  one  of 
the  severest  cases,  and  was  sent  to  London  for  the  purpose  of  an  investiga- 
tion. Subsequently  the  farm  was  visited,  and  in  the  aftcctcd  herds  some 
cases  of  equal  severity  were  found. 

"  In  a  few  cases  the  condition  was  most  distressing,  both  to  the  cow 
and  to  the  observer.  In  such  cases  the  teats  were  encrusted  with  huge 
dark  brown  or  black  crusts,  which,  when  roughly  handled  \>y  the  milker, 
were  broken  and  detached,  exposing  a  bleeding,  suppurating,  ulcerated 
base.  Such  ulcers  varied  in  size,  from  a  shilling  to  a  florin,  and  in  form 
were  circular,  ovoid,  or  irregular.  Weeks  afterwards,  when  the  animals 
had  recovered,  the  sites  of  these  ulcers  were  marked  by  irregular  scars. 
( Crookshank. ) 

Plate  XI.     CASUAL  COW  POX.     Case  of  Joseph  Brooks,  a  milker. 

(CEELY) facing  p.     358 

"  This  plate  is  referred  to  in  Vol.  II.,  p.  475  ;  it  represents  the  casual 
vaccine  on  the  right  temporo-frontal  region  of  Joseph  Brooks,  with  recedent 


LIST  OF  PL  A  TES. 


areola.  With  the  exception  of  being  rather  more  llorid,  it  very  much 
resembles  the  vaccine  vesicle  on  the  white  skin  of  the  icow's  udder,  and, 
like  that,  yielded  lymph  only  from  its  centre,  and  that  slowly  and  scantily, 
after  the  removal  of  the  central  crust." — -{Cecly.) 

Plate  XII.     CASUAL  COW  POX.     Case  of  Joseph  Brooks,  a  milker. 

(CEELY) following  Plate  XL 

"This  plate  is  referred  to  in  Vol.  II.,  p.  476;  it  represents  the  casual 
vaccine  vesicles  on  the  thumb  and  finger  of  the  same  individual,  on  the 
same  day  as  that  of  the  preceding  plate." — {Cccly.) 

Plate  XIII.     CASUAL  COW  POX.     Case  of  Joseph  White,  a  milker. 

{CEELY) facing  -p.     360 

"This  plate  is  referred  to  in  Vol  II.,  p.  491  ;  it  represents  the  casual 
vaccine  vesicles  on  the  hand  and  thumb  of  the  same  individual.  .  .  ,  The 
vesicle  on  the  thumb  is  still  flat  on  the  surface  ;  but  the  centre  is  more 
discoloured,  yet  without  any  visible  depression;  the  central  crust  has 
increased.  The  vesicle  on  the  hand  is  much  more  depressed  in  the 
centre,  and  the  bases  of  both  vesicles  are  more  elevated." — {Ceely.) 

Plate  XIV.     CASUAL  COW  POX.     Case  of  Joseph  White,  a  milker. 

{CEELY) folloiving  Plate  XII L 

Fig.  I.  "  The  vesicle  on  the  back  of  the  hand,  irregularly  puffed  at 
its  margin,  puckered  and  depressed  at  its  centre,  where  the  slough  is 
visible." 

Fig.  2.  "  The  ulcer  on  the  back  of  the  hand,  deep,  and  not  yet 
granulating,  surrounded  with  a  well-defined,  elevated,  and  indurated 
border." 

Fig.  3.  "  The  vesicle  on  the  thumb,  with  a  portion  of  slough  visible 
through  an  opening  in  the  bluish  or  slate-coloured  centre,  the  margin 
partially  vesicated,  the  base  flatter  and  duller."' 

Fig.  4.  "The  ulcer  on  the  thumb  not  very  deep,  and  granulating." 
- — Cccly. 

Plate  XV.     CASUAL  COW  POX.      Case  of  John   Harding,  milker. 

{CROOKSHANK) facing  p.     362 

"John  Harding,  the  bailiffs  son,  also  milked  the  cows.  He  had  a 
sore  on  the  upper  lid  of  his  right  eye  and  on  his  left  hand.  In  both  cases 
he  had  been  previously  scratched  by  a  cat,  and  the  scratches  were  inoculated 
from  the  cow's  teats.  The  right  hand  also  had  been  inoculated.  The  eruption 
broke  out  a  fortnight  ago.  His  hands  were  swollen,  red,  and  hot.  He  felt 
very  poorly  and  went  to  bed.  Little  spots  like  white  blisters  appeared 
on  the  back  of  his  right  hand.  His  mother  remarked  that  they  "rose 
up  exactly  as  in  vaccination."  Thick  dark  brown  scabs  formed.  He  was 
viiy  ill  for  two  or  three  days,  but  did  not  send  for  a  doctor.  He  had 
painful  lumps  at  the  bend  of  his  arm  and  in  the  armpit.  He  gave  up 
milking,  and  had  not  taken  to  it  since. 

"On  examining  him  the  thick  crusts  on  his  right  hand  were  identical 
with  the  stage  of  scabbing  in  ordinary  vaccination.  The  scabs  fell  off  in 
about  three  weeks  to  a  month,  and  left  permanent  depressed  scars." — 
{ Crooh^haith. ) 


LIST  OF  PLATES. 


Platk  XVI.     CASUAL  COW  I'(  )X.    ( .'asc  ol"  William  Plnwman,  a  milker. 

(CROOKSHANK) facm<(  p.     364 

"This  case  was  pointed  out  to  inc  on  the  occasion  of  mj'  visit  on 
December  2nd,  and  is  the  only  one  in  which  I  was  fortunate  enough  to 
see  the  eruption  in  its  oarlj-  stages.  The  case  was  of  such  extreme 
interest  that  I  took  the  lad  to  London  on  the  following  day. 

"The  historj'  of  this  boy  is  as  follows.  He  had  taken  the  place  of  one 
of  the  other  milkers  who  had  vesicles  on  his  fingers  and  had  been  obliged 
to  give  up  milking.  After  the  seventh  time  of  milking  he  noticed  a  small 
pimple  on  his  right  cheek.  This  occurred  on  Sundaj',  November  27th. 
The  pimple  became  larger,  and,  as  he  expres.sed  it,  '  rose  up  like  a 
blister.' 

"On  December  2nd,  the  date  of  my  visit,  there  was  a  large  depressed 
vesicle  with  a  small  central  yellowish  crust  and  a  tumid  margin,  the  whole 
being  surrounded  by  a  well-marked  areola  and  considerable  surrounding 
induration. 

"After  making  a  coloured  drawing  of  the  eruption  (fig.  i),  I  punctured 
the  tumid  margin,  and  collected  clear  lymph  in  a  number  of  capillary 
tubes. 

"  After  this  I  raised  the  central  incrustation,  and  pointed  out  to  the 
Inspectors  of  the  Agricultural  Department  who  were  present  the  crater- 
like excavation,  from  which  lymph  welled  up  and  trickled  down  the  boy's 
cheek. 

"On  the  following  day  the  crust  had  reformed,  and  was  studded  with 
coagulated  h^mph.  The  areola  became  more  marked,  and  on  pricking  the 
margin  of  the  vesicle  the  contents  were  slightlj-  turbid. 

"  From  this  day  the  surrounding  infiltration  increased  enormously,  the 
whole  cheek  was  inflamed,  and  the  ej'elids  so  CEdematous  that  the  eye  was 
almost  closed.  There  was  enlargement  of  the  neighbouring  lymphatic 
glands.  The  crust  which  had  reformed,  thickened  day  by  day,  and 
on  December  9th,  when  I  took  the  boy  to  Sir  James  Paget,  there  was  a  thick 
reddish-brown  or  mahogany-coloured  crust,  still  bearing  the  character 
of  central  depression,  surmounting  a  reddened,  elevated,  and  indurated 
base.     (Fig.  2.) 

"From  this  date  the  surrounding  induration  gradually  diminished. 
The  crust  changed  in  colour  from  dark-brown  to  black,  and  finally  fell  oft' 
on  December  15th,  leaving  an  irregular  depressed  scar.  This  scar,  when 
seen  se\-eral  months  afterwards,  was  found  to  be  a  permanent  disfigure- 
ment. 

"Thus  the  eruption  appeared  on  the  fourth  day  after  exposure  to 
infection,  and  allowing  two  days  for  incubation,  the  vesicle  was  at  its 
height  on  the  seventh  or  eighth  day,  and  a  typical  tamarind-stone  crust 
fell  off  on  the  twenty-first  day  after  infection,  leaving  a  depressed, 
irregular  cicatrix.'" — {Crookshank.) 


Plate  XVII.     CASUAL  COW  POX.     Cases  of  William  Plowman  and 

William  Hibbi-rt.  milkers.     (CROOKSHANK' ]   .    follonun<i  Plate  XIV. 

Figs.  I,  2,  3,  represent  the  thumb  of  William  Plowman.  Sec  also 
description  of  the  preceding  plate. 

"A  vesicle  also  formed  on  the  thumb  of  the  left  hand.  Two  days 
after  the  pimple  appeared  on  his  cheek,  the  lad  says  that  he  noticed  a 
pimple  on  his  thumb,  and   this,  on  my  visit  on   December  2nd,  presented  a 


LIST  OF  PLATES. 


greyish  flattened  vesicle,  about  the  size  of  a  sixpence.  On  the  following 
day  its  vesicular  character  was  much  more  marked,  and  a  little  central 
crust  had  commenced  to  form.  (Fig.  I.)  On  the  Sunday,  especially 
towards  the  evening,  the  margins  became  very  tumid,  giving  it  a  marked 
appearance  of  central  depression.  On  Monday,  December  5th,  I  punctured 
the  vesicle  at  its  margin  with  a  clean  needle,  and  filled  a  number  of 
capillary  tubes  from  the  beads  of  lymph  which  exuded. 

"On  Wednesday,  December  7th,  suppuration  had  commenced;  the 
vesicle  contained  a  turbid  fluid,  and  the  areola  was  well  marked.  (Fig.  2.) 
On  December  9th  the  crust  had  assumed  a  peculiar  slate-coloured  hue, 
and,  on  pressing  it,  pus  welled  up  through  a  central  fissure.  (Fig.  3.) 
The  areola  had  increased,  and  there  was  considerable  inflammatory 
thickening.  The  lymphatic  glands  in  the  armpit  were  enlarged  and 
painful.  Though  there  was  deep  ulceration,  which  left  a  permanent  scar, 
the  ulceration  did  not  assume  quite  so  severe  a  character  as  in  some  of  the 
other  milkers." 

Fig.  4.     Case  of  William  Hibbert,  junr. 

"William  Hibbert,  a  milker,  states  that  he  had  both  hands  bad  about 
a  month  ago.  First  the  index  finger  of  the  left  hand,  and  then  the  right 
hand  on  his  knuckle  and  between  the  first  and  second  fingers. 

"  He  says  that  it  came  up  like  a  hard  pimple,  and  the  finger  became 
swollen  and  red.  After  a  few  days  it  '  weeped  out '  water  and  then 
matter  came  away.  Both  his  arms  were  swollen,  but  his  left  arm  was  the 
worst. 

"About  a  fortnight  after,  he  noticed  'kernels'  in  his  armpits,  which 
were  painful  and  kept  him  awake  at  night.  His  arms  became  worse,  he 
could  not  raise  them,  and  he  had  to  give  up  milking.  He  also  had  had  a 
'bad  place'  on  the  lower  lip. 

"On  examination,  I  found  that  the  axillary  glands  were  still  enlarged 
and  tender." — ( CrooksJiaiik.) 

Plate  XVIII.     NATURAL  HORSE  POX.     {PEUCH)  .        fariir^  p.  404 

Eruption  of  Horse  Pox  on  the  penis  of  a  stallion. 

H.  Loubat  pinxit,  April  15,  1879. 

For  reference  to  this,  and  the  following  plates  see  pp.  402-418. 

Plate  XIX.    NATURAL  HORSE  POX.    {PEUCH)foUozi<ing  Plate  XVIII. 

Perivu'var  eruption  of  Horse  Pox  in  a  five-year-old  mare. 
H.  Loubat  pinxit,  April  26,  1883. 

Plate  XX.     NATURAL  HORSE  POX  SIMULATING  APHTHOUS 

STOMATITIS.     [PEUCH) facing  p.     406 

Eruption    of   Horse    Pox  on  the  nose  and   lips,  consisting  of  pearly 
bullous  vesicles;  resembling  both  aphthous  stomatitis  and  glanders. 
H.  Loubat  pinxit,  April  27,  1S80. 

Plate  XXI.     NATURAL  HORSE  POX  SIMULATING  GLANDERS. 

{PEUCH) foUozvhig  Plate  XX. 

Nasal  eruption  of  Horse  Pox  in  the  stage  of  ulceration  ;  resembling 
glanders. 

H.  Loubat  pinxit,  1880. 


LIST  OF  PL  A  TES. 


Plate  XXII.     ROSEOLA  OF  COW  POX.     {]VTr.I.A.\\     facinir  p.     460 

"  Roseola  vaccina  ;  an  cilloresccncc  which  commonly  appears  in  a 
congeries  of  dots  and  small  patches,  as  here  represented,  but  is  sometimes 
diffuse;  like  the  variolous  rash  it  usually  occurs  at  the  same  time  with  the 
areola,  and  around  the  inoculated  part." — (1117/iiii.) 


Plate  XXIII.     INOCULATED  SYPHILIS.     (^R/CORD)      facing  p.     462 

"Fig  I.  Result  of  an  inoculation,  made  on  January  13th,  at  half  past 
nine  in  the  morning,  with  pus  collected  at  the  margin  of  the  prepuce. 
Drawing  made  at  ten  o'clock.  Tumefaction  of  the  tissues  is  already 
observable,  and,  in  the  centre,  the  puncture  of  the  lancet  is  surrounded  by 
a  slight  reddish  areola  almost  limited  to  the  swollen  parts. 

"  Fig.  2.  Drawing  made  on  the  same  day  at  four  o'clock  in  the  after- 
noon. The  inoculated  spot  is  more  elevated  ;  the  areola  is  more  deeply 
coloured. 

"Fig.  3.  Drawing  made  on  January  14th,  at  nine  o'clock  in  the 
morning.  The  swollen  parts  are  sharply  circumscribed,  and  have  a  deep 
red  colour  at  the  base.  A  greyish  point  at  the  summit  corresponds  with 
the  puncture  of  the  lancet.  .  .  .  The  inflammatory  areola  has,  comparatively 
speaking,  extended  considerably. 

"Fig.  4.  Drawing  made  on  the  same  day  at  four  o'clock  in  the 
afternoon.  The  pustule  has  developed  ;  the  greyish  spot  noticed  in  the 
morning  has  become  quite  black,  and  forms  a  small  gangrenous  eschar, 
and  around  it  tiie  epidermis  is  raised  up  by  pus. 

"Fig.  5-  Drawing  made  on  the  15th,  at  ten  o'clock  in  the  morning. 
All  the  parts  of  the  pustule  have  advanced  in  equal  proportion. 

"Fig.  6.  Drawing  made  on  the  l6th,  at  ten  o'clock  in  the  morning. 
A  general  advance.  There  is  an  irregularity  at  the  periphery  of  the 
pustule,  from  which  a  small  quantity  of  pus  has  escaped  during  the  night, 
and  in  the  centre  the  gangrenous  eschar  is  depressed,  and  appears  to  be 
adherent  to  the  underlying  parts. 

"Fig.  7.  Drawing  made  on  the  17th,  at  ten  o'clock  in  the  morning. 
A  general  advance.  The  pustule  has  ruptured  at  several  points,  and 
appears  to  be  almost  free  from  pus. 

"Fig.  8.  Drawing  made  on  the  i8th,  at  ten  o'clock  in  the  morning. 
A  general  advance,  with  the  exception  of  the  inflammatory  areola,  which 
appears  less  intense.  On  raising  the  irregular  slough  which  covers  the 
ulcer  resulting  from  the  inoculation,  a  red  base  marked  with  yellowish 
points  is  disclosed.  At  the  edges,  a  whitish  margin  is  seen  formed  by  the 
elevated  epidermis."  {Traitc  coiiipkt  des  Maladies  Ve'neriemies,  Plate  III., 
Figs.  2-8.     Paris  1851.) 


HISTORY    AND    PATHOLOGY 

O  F 

VACCINATION. 


CHAPTER  I. 


HISTORY  OF  SMALL  POX  INOCULATION  IN  FOREIGN 
COUNTRIES. 

The  practice  of  Small  Pox  inoculation  is  one  of  very 
great  antiquity.  It  had  been  found  by  experience  that 
a  person  was  not,  as  a  rule,  seized  with  Small  Pox 
a  second  time ;  but  when,  and  how,  the  method  of. 
artificially  inducing  the  disease  was  discovered,  or  where 
this  preventive  treatment  was  first  employed,  is  quite 
unknown.  It  has  been  suggested,  not  unnaturally,  that 
as  the  Arabian  physicians  were  acquainted  with  the 
nature  and  treatment  of  Small  Pox,  they  were  probably 
the  first  to  whom  it  occurred  to  produce  the  disease 
by  inoculation.  Avicenna,  who  is  said  to  have  lived 
at  Bokhara,  on  the  east  coast  of  the  Caspian  Sea,  has 
been  credited  with  this  discovery ;  and  it  was  supposed 
that  the  practice  was  carried  by  Tartar  and  Chinese 
traders    to     Surat,     Bengal,    and    China,     and     by    the 

VOL.  I.  I 


SMALL  POX  LNOCULATION. 


Mahommedan  pilgrims  to  Mecca.  But,  according  to 
Woodville/  there  is  little  or  nothing  to  support  this 
theory,  for  there  is  no  evidence  that  the  Circassians, 
or  any  of  the  inhabitants  of  the  countries  near  the 
Caspian  Sea,  had  practised  the  art  of  inoculation  longer 
than  those  of  other  nations  ;  and  D'Entrecolles  had 
remarked  that  the  Tartars  were  ignorant  of  this  treat- 
ment in    1724. 

There  were  equally  conflicting  opinions  in  Con- 
stantinople as  to  the  origin  of  inoculation.  It  was  said 
by  some  to  have  been  introduced  from  the  Morea  by 
an  old  woman,  and  by  others  to  have  been  imported 
from  Circassia,  where  it  was  supposed  to  have  been 
first  employed.  Dr.  Mead^  was  in  favour  of  the 
latter    view. 

"  I  have  often  wondered  how  such  a  notion  could  come  into  the 
heads  of  people  almost  quite  ignorant  of  what  relates  to  physic. 
For,  as  far  as  I  have  been  able  to  find  out  by  inquiry,  this  was  the 
invention  of  the  Circassians,  the  women  of  which  country  are  said 
to  excel  in  beauty  ;  upon  which  account  it  is  very  common,  espe- 
cially among  the  poorer  sort,  to  sell  young  girls  for  slaves  to  be 
carried  awa}^  into  the  neighbouring  parts.  When  therefore  it  was 
observed  that  they  who  were  seized  with  this  distemper  were  in 
less  danger  both  of  their  beauty  and  their  life  the  younger  they 
were,  they  contrived  this  way  of  infecting  the  body  that  so  the 
merchandise  might  bring  the  greater  profit." 

In    Circassia.— De  la    Motraye,'^  in   171 1,    saw  the 

'  Woodvillc,  The  History  of  the  Inoculation  of  the  Small-Pox,  p.  35. 
1796. 

*  Medical  Works  of  Dr.  Richard  Mead,  vol.  ii.,  p.  143.     1765. 

^  Ue  la  Motraye,  Travels  through  Europe,  Asia,  and  into  Part  of 
Africa,  vol.  ii.,  p.  75.      1723. 


FOREIGN  COUNTRIES. 


openition  performed  upon  a  Circassian  girl  four  or  five 
years  old.  The  girl,  after  being  purged  with  dried 
fruit,  was  carried  to  a  boy  about  three  years  old,  who 
had  caught  the  natural  Small  Pox,  and  whose  pocks 
were  ripe.  An  old  woman  performed  the  operation  ; 
for  women  of  advanced  age  exercised  the  practice  of 
physic  in  Circassia.  The  manner  of  inoculating  the 
disease  was  thus  described  : — 

"  She  took  three  needles  fastened  together,  and  prick'd  first  the 
pit  of  the  stomach  ;  secondly,  directly  over  the  heart ;  thirdly,  the 
navel  ;  fourthly,  the  right  wrist ;  and,  fifthly,  the  ankle  of  the  left 
foot,  till  the  blood  came.  At  the  same  time,  she  took  some  matter 
from  the  pocks  of  the  sick  person,  and  applied  it  to  the  bleeding 
part,  which  she  covered,  first,  with  angelica  leaves  dri'd,  and  after 
with  some  of  the  youngest  Iamb-skins  ;  and  having  bound  them  all 
well  on,  the  mother  wrapped  her  daughter  up  in  one  of  the  skin 
coverings,  which.  I  have  observed,  compose  the  Circassian  beds, 
and  carried  her  thus  packed  up  in  her  arms  to  her  own  home  ; 
where  (as  they  told  me)  she  was  to  continue  to  be  kept  warm,  eat 
only  a  sort  of  pap  made  of  cummin  flower,  with  two-thirds  water 
and  one-third  sheep's  milk,  without  either  flesh  or  fish,  and  drink 
a  sort  of  tisan,  made  with  angelica,  biigloss  roots,  and  licorish,  which 
are  all  very  common  throughout  this  country;  and  they  assured  me 
that  with  this  precaution  and  regimen,  the  Small  Pox  generally 
came  out  very  favourably  in  five  or  six  days." 

In  Constantinople.— The  first  publication  in  England 
giving  a  description  of  the  custom  of  inoculating  or 
ingrafting  the  Small  Pox,  was  written  by  Kennedy,^  a 
surgeon  : 

"  I  rather  more   particularly    take   notice  here  of  the  way   or 

'Kennedy,  A71  Essay  un  External  Remedies, -p.  153.    I, on  don,  1715. 


SMALL  POX  INOCULATION. 


manner  of  giving  the  Small  Pox,  to  show  or  confirm  how  easily 
distempers  or  contagious  corpuscles  or  malignity  (as  well  as 
medecines)  may  be  communicated  to  the  blood.  This  of  giving  or 
ingrafting  the  Small  Pox  was  practised  in  the  Peloponnesus  (now 
called  \\\&Morca),  and,  at  this  present  time,  is  very  much  used  both 
in  Turkey  and  Persia,  where  they  give  it  in  order  to  prevent  its 
more  dismal  effects  by  the  early  knowledge  of  its  coming,  as  also 
probably  to  prevent  their  being  troubled  with  it  a  second  time. 
This  method  of  the  Persians  is  to  use  the  Pock  and  matter  dried 
into  powder,  the  which  they  take  inwardly;  but  the  common  way 
now  used  in  Turkey,  and  more  particularly  at  Constantinople,  is 
thus  :  they  first  take  a  fresh  and  kindly  Pock  from  some  one  ill  of 
this  distemper,  and  having  made  scarifications  upon  the  forehead, 
wrists,  and  legs,  or  extremities,  the  matter  of  the  Pock  is  laid  upon 
the  foresaid  incision,  being  bound  on  there  for  eight  or  ten  days 
together;  at  the  end  of  which  time,  the  usual  symptoms  begin  to 
appear,  and  the  distemper  comes  forward  as  if  naturally  taken  ill, 
though  in  a  more  kindly  manner  and  not  near  the  number  of  Pox. 
During  this  time,  or  from  the  scarifications  being  made,  the  patient 
is  closely  confined  to  his  room,  so  as  in  no  way  to  be  exposed  to 
the  air  ;  and  the  regimen  or  diet  during  the  whole  time  of  confine- 
ment is  altogether  from  flesh,  and  one  kept  mostly  to  water-gruel. 
By  this  very  regular  way  of  living,  the  distemper  or  Pock  comes 
out  more  kindly  and  less  dangerous  ;  since  it  is  very  probable  that 
most  of  the  malignity  is  increased  and  augmented  by  the  irregu- 
larities committed  in  their  diet  or  their  manner  of  living  some 
few  days  before  the  malady  appears — which,  when  it  comes  natur- 
ally, cannot  be  so  well  seen  or  known  how  to  prevent  its  worst 
symptoms,  so  as  when  given  after  this  manner.  Whilst  as  yet 
there,  I  was  credibly  inform'd,  both  by  the  physicians  and  mer- 
chants, that  of  the  number  of  two  thousand  which  had  then  lately 
undergone  that  method,  there  were  not  any  more  than  two  who  I 
died,  their  deaths  being  altogether  attributed  to  their  want  of  care;  } 
for,  having  been  scarified,  and  the  Small  Pox  applied  to  the  part,  ; 
the  symptoms  not  appearing  so  soon  as  commonly  or  as  they 
expected,  they  went  abroad,  exposing  themselves  to  the  open  air, 
which  struck  the  distemper  or  malignity  to  the  centre,  or  more 
inwardly,  and  was  the  occasion  of  their  death. 


FOREIGN  COUNTRIES. 


"  Dr.  Janoin,  a  Grecian,  who  resides  there,  had  taken  or  followed 
this  same  method  with  his  two  sisters,  a  little  before  my  arrival 
at  Constantinople.  The  greatest  objection  commonly  proposed 
is,  whether  or  not  it  hinders  the  patient  from  being  infected 
a  second  time.  But  in  answer  to  this,  it  is  advanced  that  we 
do  rarely  or  never  find  any  to  have  been  troubled  with  this 
distemper  twice  in  the  same  manner,  or  the  same  fulness 
of  malignity.  For  when  it  happens  the  second  time  it  generally 
proves  that  commonly  called  the  Bastard  or  Hog  Pox,  which 
is  empty  or  skinny,  and  very  little  matter  or  malignit}'  con- 
tained in   it. 

"So  that  it  is  presumed  to  be  some  seminal  matter,  in  the 
very  Euibrio  or  Parent,  and  only  makes  its  appearance  by  some 
proper  accident,  medium,  or  means  of  air,  aliment,  contact,  or 
the  like,  varying  according  to  our  different  natures  and 
constitutions. 

"  But,  however,  my  intention  here  is  not  with  a  design  to 
introduce  this  practice  into  these  parts  ;  though  the  veracity 
of  what  I  have  advanced  is  not  to  be  doubted,  since  there 
are  several  merchants  or  gentlemen  who,  having  lived  there, 
that  know  it  to  be  a  truth  :  we  in  Britain  probably  being 
more  timorous  and  fearful  of  our  lives  in  this  case,  because 
of  the  great  mortalities  which  so  frequently  accompany  this 
distemper  with  us ;  though  of  this  method,  as  those  who 
practise  it  assert,  or  maintain  it  to  be,  it  need  be  no  more 
minded   than  giving  or  taking  the  ItchP 

The    practice    among     the    Turks     was    more     fully 

described  by   Dr.  Emanuel   Timoni,   and   communicated 

by    Dr.   Woodward  to   the    Royal    Society.^ 

"  The  writer  of  this  ingenious  discourse  observes,  in  the  first 
place,  that  the  Circassians,  Georgians,  and  other  Asiatic/cs  have 
introduc'd  this  practice  of  procuring  the  Small  Pox  by  a  sort 
of  inoculation,  for  about  the  space  of  forty  years  among  the 
Turks  and  others  at    Constantinople. 

'  Woodward,  P/zz7.  Trans.,  iji"},  vol.  xxix.,  for  the  years  1714,  ij^b' 
1716,  pp.  72-4. 


SMALL   POX  INOCULATION. 


"That  although  at  first  the  more  prudent  were  very  cautious 
in  the  use  of  this  practice  ;  yet  the  happy  success  it  has  been 
found  to  have  in  thousands  of  subjects  for  these  eight  years 
past  has  now  put  it  out  of  all  suspicion  and  doubt ;  since  the 
operations  having  been  perform'd  on  persons  of  all  ages,  sexes, 
and  different  temperaments,  and  even  in  the  worst  constitution 
of  the  air,  yet  none  have  been  found  to  die  of  the  Small  Pox  ; 
when  at  the  same  time  it  was  very  mortal  when  it  seized  the 
patient  the  common  way,  of  which  half  the  affected  dy'd.  This 
he  attests  upon  his  own  observation. 

"  Next  he  observes  they  that  have  this  inoculation  practised 
upon  them  are  subject  to  very  slight  symptoms,  some  being  scarce 
sensible  they  are  ill  or  sick;  and,  what  is  valued  by  the  fair, 
it  never   leaves  an}^  scars  or  pits  in   the  face. 

"  The  method  of  the  operation  is  thus : — Choice  being  made 
of  a  proper  contagion,  the  matter  of  the  pustules  is  to  be  com- 
municated to  the  person  proposed  to  take  the  infection,  whence 
it  has  metaphorically  the  name  of  insition  or  inoculation. 

"  For  this  purpose  they  make  choice  of  some  boy  or  young  lad, 
of  a  sound  healthy  temperament,  that  is  seized  with  the  common 
Small  Pox  (of  the  distinct,  not  flux  sort),  on  the  twelfth  or 
thirteenth  day  from  the  beginning  of  his  sickness ;  they,  with 
a  needle,  prick  the  tubercles  (chiefly  those  on  the  shins  and 
hams),  and  press  out  the  matter  coming  from  them  into  some 
convenient  vessel  of  glass,  or  the  like,  to  receive  it.  It  is 
convenient  to  wash  and  clean  the  vessel  first  with  warm  water. 
A  convenient  quantity  of  this  matter  being  thus  collected  is  to 
be  stopped  close  and  kept  warm  in  the  bosom  of  the  person 
that  carries  it,  and  as  soon  as  may  be,  brought  to  the  place 
of  the  expecting  future  patient.  The  patient,  therefore,  being 
in  a  warm  chamber,  the  operator  is  to  make  several  little  wounds 
with  a  needle  in  one,  two,  or  more  places  of  the  skin  till  some 
drops  of  blood  follow,  and  immediately  drop  out  some  drops 
of  the  matter  in  the  glass,  and  mix  it  well  with  the  blood 
issuing  out ;  one  drop  of  the  matter  is  sufficient  for  each  place 
prick'd.  These  punctures  are  made  indifferently  in  any  of  the 
fleshy  parts,  but  succeed  best  in  the  muscles  of  the  arm  or 
radius.      The  needle  is  to  be  a  3-edg'd  surgeon's  needle ;  it  may 


FOREIGN  COUNTRIES. 


likewise  be  perform'd  with  a  lancet.  The  custom  is  to  run 
the  needle  transverse  and  rip  up  the  skin  a  little,  that  there  may 
be  a  convenient  dividing  of  the  part,  and  the  mixing  of  the 
matter  with  the  blood  more  easily  perform'd ;  which  is  done 
either  with  a  blunt  stile  or  an  ear-picker.  The  wound  is 
cover'd  with  half  a  walnut  shell  or  the  like  concave  vessel,  and 
bound  over,  that  the  matter  be  not  rub'd  off  by  the  garments  ; 
which  is  all  removed  in  a  few  hours.  The  patient  is  to  take 
care  of  his  diet.  In  this  place,  the  custom  is  to  abstain  wholly 
from  flesh  and  broth  for  twenty  or  twent3'-five  days.  This 
operation  is  performed  either  in  the  beginning  of  the  winter 
or  in  the  spring.  ...  It  was  observ'd  in  a  year  when  the 
common  Small  Pox  w'as  very  mortal,  that  those  by  incision 
were  also  attended  with  greater  s3'mptoms.  Of  fifty  persons, 
who  had  the  incision  made  upon  them  almost  in  the  same 
day,  four  were  found  in  whom  the  eruption  was  too  sudden, 
the  tubercles  more,  and  symptoms  worse.  There  was  some 
suspicion  that  these  four  had  caught  the  common  Small  Pox 
before  the  incision  was  made.  It  is  enough  for  our  present 
purpose  that  there  was  not  one  but  recovered  after  the 
incision ;  in  these  four  the  Small  Pox  came  near  the  confluent 
sort.  At  other  times  the  inoculated  are  distinct,  few,  and 
scattered ;  commonly  ten  or  twenty  break  out ;  here  and  there  one 
has  but  two  or  three,  few  have  100.  There  are  some  in  whom 
no  pustule  rises,  but  in  the  places  where  the  incision  was 
made,  which  SAveU  up  into  purulent  tubercles ;  yet  these  have 
never  had  the  Small  Pox  afterwards  in  their  w^hole  lives,  tho' 
they   have   cohabited    with  persons  having   it." 

Another  account  of  the  Byzantine  method  of 
inoculation  was  pubhshed  by  Dr.  Pylarini,^  v^ho 
described  the  operation  as  it  was  performed  in  his 
presence  upon  four  sons  of  a  Greek  nobleman,  by  an 
old  woman   who  had    long    practised   inoculation.     The 

'  Pylarini,  F/i//.   Trans.,  1716,  vol.  xxix.,  p.  393. 


SMALL  POX  LNOCULATION. 


variolous  matter  was  inserted  into  a  number  of 
punctures  made  on  the  forehead,  cheeks,  chin,  and  also 
on  both   wrists. 

In  Turkey  in  Asia.— Dr.  RusselP  gave  evidence 
of  a  similar  practice  among  the  Arabs.  In  1726, 
Dr.  Patrick  Russell,  physician  at  Aleppo,  wrote  a 
letter  to  his  brother,  who  presented  it  to  the  Royal 
Society. 

"About  nine  or  ten  years  ago,  while  on  a  visit  at  a  Turkish 
Harem,  a  lady  happened  to  express  much  anxiety  for  an  only 
child  who  had  not  yet  had  the  Small  Pox  ;  the  distemper  at 
that  time  being  frequent  in  the  city.  None  of  the  ladies  in  the 
company  had  ever  heard  of  inoculation ;  so  that  having  once 
mentioned  it,  I  found  myself  obliged  to  enter  into  a  detail  of 
the  operation,  and  of  the  peculiar  advantages  attending  it. 
Among  the  female  servants  in  the  chamber  was  an  old  Bedouin, 
who  having  heard  me  with  great  attention,  assured  the  ladies 
that  my  account  was  upon  the  whole  a  just  one,  only  that  I  did 
not  seem  so  well  to  understand  the  way  of  performing  the  opera- 
tion, which  she  asserted  should  be  done  not  with  a  lancet  but 
with  a  needle ;  she  herself  had  received  the  disease  in  that 
manner,  when  a  child ;  had,  in  her  time,  inoculated  many ; 
adding,  moreover,  that  the  practice  was  well  known  to  the  Arabs, 
and  that   they  termed  it  buying  the  Small  Pox. 

"  In  consequence  of  this  hint,  I  set  about  procuring  more 
particular  information  from  the  Arabs  of  this  place ;  and  the 
result  of  my  inquiry  was  that  the  practice  of  inoculation  had 
been  of  long  standing  among  them.  They,  indeed,  did  not 
pretend  to  assign  any  period  to  its  origin ;  but  those  of  seventy 
years  old  and  upwards  remembered  to  have  heard  it  spoken 
of  as  a  common  custom  of  their  ancestors,  and  made  little  doubt 
of  its  being  of  as  ancient  a  date  as  the  disease  itself.  Their 
manner  of  operating  is  to  make  several  punctures  in  some  fleshy 

Russell,  Phil.  Irans.,  vol.  Iviii.,  pp.  140-50. 


FOREIGN  COUNTRIES. 


part,  with  a  needle  imbued  in  variolous  matter  taken  irom  a 
favourable  kind  of  pock.  The}'  use  no  preparation  of  the  body  ; 
and  the  disease  communicated  in  this  way  being,  as  they  aver, 
always  slight,  they  give  themselves  little  or  no  trouble  about 
the  child  in  the  subsequent  stages  of  the  distemper. 

"  This  method  of  procuring  the  disease  is  termed  buying  the 
Small  Pox  on  the  following  account.  The  child  to  be  inoculated 
carries  a  few  raisins,  dates,  sugarplums,  or  suchlike  ;  and  show- 
ing them  to  the  child  from  whom  the  matter  is  to  be  taken, 
asks  how  many  pocks  he  will  give  in  exchange.  The  bargain 
being  made,  they  proceed  to  the  operation.  When  the  parties 
are  too  young  to  speak  for  themselves,  the  bargain  is  made  by 
the  mothers.  This  ceremony,  which  is  still  practised,  points  out 
a  reason  for  the  name  given  to  inoculation  by  the  Arabs  ;  but 
by  what  I  could  learn  among  the  women,  it  is  not  regarded  as 
indispensably  necessary  to  the  success  of  the  operation,  and  is, 
in  fact,  often  omitted." 

Dr.  Russell  found  that  the  same  custom  prevailed 
among  the  Eastern  Arabs,  not  only  at  Bagdad  and 
Mousul,  but  in  Bassora.  At  Mousul,  the  appear- 
ance of  Small  Pox  was  announced  by  a  public  crier, 
so  that  those  who  wished  might  have  their  children 
inoculated. 

"  In  Armenia,  the  Turkoman  tribes  as  well  as  the  Armenian 
Christians  have  practised  inoculation  since  the  memor}-  of  man  ; 
but,  like  the  Arabs,  are  able  to  give  no  account  of  its  first 
introduction  among  them.   .  .   . 

"  At  Damascus,  and  all  along  the  coast  of  Syria  and  Palestine, 
inoculation  has  been  long  known.  In  the  Castravan  mountains 
it  is  adopted  b}-  the  Drusi  as  well  as  the  Christians. 

"  Whether  the  Arabs  of  the  desart  to  the  South  of  Damascus 
are  acquainted  with  this  manner  of  communicating  the  Small 
Pox,  I  have  not  hitherto  been  able  to  learn  ;  but,  a  native  of 
Mecca,  whom  I  had  occasion  to  converse  with  this  summer, 
assured  me  that  he  himself  had  been  inoculated  in  that  city.   .   .   . 


SMALL   POX  LNOCULATLON. 


"In  the  different  countries  above-mentioned,  inoculation  is 
performed  nearly  in  the  same  manner.  The  Arabs  affirmed  that 
the  punctures  might  be  made  indifferently  in  any  fleshy  part. 
Those  I  have  had  occasion  to  examine,  have  all  (a  very  few 
excepted)  had  the  mark  between  the  thumb  and  the  fore-finger. 

"  Some  of  the  Georgians  had  been  inoculated  in  the  same  part, 
but  most  of  them  on  the  fore-arm.  Of  the  Armenians,  some  had 
been  inoculated  in  both  thighs,  but  the  greater  part  (like  the 
Arabs)  bore  the  marks  upon  the  hand.  Some  of  the  Georgian 
women  remembered  that  rags  of  a  red  colour  were  chosen  in 
preference  for  the  binding  up  the  arm,  a  circumstance  of  which 
I  have  been  able  to  discover  no  trace  among  the  Arabs." 

In  Africa. — Mr.  Colden^  thought  that  inoculation 
originated  in  Africa.  The  negroes  in  Senegal,  when- 
ever the  Small  Pox  visited  them,  inoculated  their 
children  on  the  arm.  The  inoculated  abstained  from 
animal  food,  and  drank  freely  water  acidulated  with 
the  juice  ot  limes. 

In  other  parts  of  Africa  a  similar  custom  existed. 
Here  also  it  was  called  buying  ike  Small  Pox,  and 
there  was  a  superstition  that  inoculation  would  be  of 
no  avail,  unless  the  person  from  whom  the  variolous 
matter  was  taken,  received  a  piece  of  money  or  some 
other  article  in  exchancre. 

The  practice  of  inoculation  in  Tripoli,  Tunis,  and 
Algiers  was  described  by  Cassem  Aga,"  ambassador  in 
England  in   1728. 

'  Colden,  Med.  Obs.  and  Iiiq.,  vol.  i.,  p.  228. 

''  Scheuclizcr,  An  Account  of  the  Success  of  Luoculating  the  Small 
Pox,  p.  61  ;  A  Paper  relating  to  the  Inoculation  of  the  Sjnall-Pox  as 
it  is  -practised  in  the  Kingdoms  of  Tripoli,  Tunis,  andAlgier.  Written 
in  Arabic  by  His  Excellency  Cassem  Aga,  Ambassador  from  Tripoli, 
F.R.S.     Done  into  English  from  the  French  of  Mr.  Dadichi." 


FOREIGN  COUNTRIES. 


"  My  opinion  being  asked  relating  to  the  inoculation  of  the  Small 
Pox,  I  will  mention  in  a  lew  words  what  I  know  of  it.     If  any  one 
hath  a  mind  to  have  his  children  inoculated,  he  carries  them  to  one 
that  lies  ill  of  the  Small  Pox  at  the  time  when  the  pustules  are 
come  to  full  maturity.     Then  the  surgeon  makes  an  incision  on 
the  back  of  the  hand  between  the  thumb  and  forefinger,  and  puts 
a  little  of  the  matter  squeezed  out  of  one  of  the  largest  and  fullest 
pustules  into  the  wound.     This  done,  the  child's  hand  is  wrapp'd 
up  with  a  handkerchief  to  keep  it  from  the  air,  and  he  is  left  to  his 
liberty  till  the  fever  arising  confines  him  to  his  bed,  which  com- 
monly happens  at  the  end  of  three  or  four  days.     After  that,  by 
God's  permission,  a  few  pustules  of  the  Small  Pox  break  out  upon 
the  child.      All  this  I  can  confirm  by  a  domestic  proof;  for  my 
father  carried  us,  five  brothers  and  three  sisters,  to  the  house  of  a 
girl  that  lay  ill  of  the  Small  Pox,  and  had  us  all  inoculated  the 
same  day.     Now  he  that  had  most  of  us  all,  had  not  above  twenty 
pustules.     Otherwise  this  practice  is  so  innocent  and  so  sure  that 
out  of  a  hundred  persons  inoculated  not  two  die  ;  whereas,  on  the 
contrar}',    out  of  a   hundred   persons   that  are  infected  with  the 
Small  Pox  the  natural  way,  there  die  commonly  about  thirt3\     It 
is  withal  so  ancient  in  the  kingdoms  of  Tripoli,  Tunis,  and  Algiers, 
that  nobody  remembers  its  first  rise ;  and  it  is  generally  practised 
not  only  by  the  inhabitants  of  the  towns,  but  also  by  the  wild 
Arabs." 

Dr.  Shaw,^  also,  has  given  an  account  of  the  practice 
of  inoculation  in  Barbary.  According  to  his  description 
the  variolous  pus  was  applied  to  a  slight  wound. 

"  The  inoculation  of  them  is  performed  by  making  a  slight 
wound  upon  the  fleshy  part  of  the  hand  betwixt  the  thumb  and 
the  forefinger.  The  person  who  is  to  undergo  the  operation 
receives  the  infection  from  some  friend  or  neighbour  who  hath  a 
favourable  kind,  and  who  is  entreated  to  sell  two  or  three  of  his 
pustules    for    the    same    number    of    nuts,    comfits,    or    suchlike 

•  Shaw,  Travels  and  Observations  relating  to  Several  Farts  of 
Barba?-y  atid  the  Levant,  p.   265.     1738. 


SMALL  FOX  INOCULATION. 


trifles.  This  they  call  purchasing  of  the  Small  Pox  ;  and  among 
the  Jeivs,  the  purchase  alone  I  was  told,  without  inoculation,  was  a 
sufficient  preparative  for  the  infection. 

"  However,  it  is  in  no  great  repute  in  those  parts  of  Barbary  or 
the  Levant  where  I  have  been ;  most  people  esteem  it  to  be  a 
tempting  of  Providence,  and  the  soliciting  a  distemper  before 
Nature  is  disposed  to  receive  it.  Accordingly  they  tell  a  number 
of  stories  to  discourage  the  practice  ;  particularly  of  a  beautiful 
young  lady  who  purchased  only  a  couple  of  pustules.  It 
happened  indeed  she  had  no  more  than  were  paid  for  ;  but  the 
misfortune  was,  they  fell  upon  her  eyes,  and  she  was  blind  by 
the  experiment." 

In  India. — Inoculation,  according  to  tradition,  was 
a  most  ancient  custom  in  India.  We  are  indebted  to 
Holwell  ^  for  full  details  of  the  practice. 

"  Inoculation  is  performed  in  Indostan  by  a  particular  tribe  of 
Brahmins,  who  are  delegated  annually  for  this  service  from  the 
different  colleges  of  Bindoobund,  Eleabas,  Banaras,  etc.,  over  all 
the  distant  provinces ;  dividing  themselves  into  small  parties  of 
three  or  four  each,  they  plan  their  travelling  circuits  in  such  wise 
as  to  arrive  at  the  places  of  their  respective  destination  some 
weeks  before  the  usual  return  of  the  disease  ;  they  arrive  com- 
monly in  the  Bengal  provinces  early  in  February,  although  they 
some  years  do  not  begin  to  inoculate  before  March,  deferring  it 
until  they  consider  the  state  of  the  season,  and  acquire  informa- 
tion of  the  state  of  the  distemper.  .  .   . 

"  The  inhabitants  of  Bengal,  knowing  the  usual  time  when  the 
inoculating  Brahmins  annually  return,  observe  strictly  the  regimen 
enjoined,  whether  they  determine  to  be  inoculated  or  not ;  this 
preparation  consists  only  in  abstaining  for  a  month  from  fish, 
milk,  and  ghee  (a  kind  of  butter  made  generally  of  buffalo's  milk)  ; 
the  prohibition  of  fish  respects  only  the  native  Portuguese  and 
Mahomedans  who  abound  in  every  province  of  the  empire.     When 


'  Holwell,  An  Accoimt  of  the  Manner  of  Inoculating  the  Small  Pox 
in  the  East  Indies,  pp.  8-19.    1767. 


FOREIGN  COUNTRIES.  13 

the  Brahmins  begin  to  inoculate,  they  pass  from  house  to  house 
and  operate  at  the  door,  refusing  to  inoculate  any  who  have  not 
on  a  strict  scrutiny,  duly  observed  the  preparatory  course  enjoined 
them.  It  is  no  uncommon  thing  for  them  to  ask  the  parents  how 
many  pocks  they  chuse  their  children  should  have.  Winity,  we  should 
think,  urged  a  question  on  a  matter  seemingly  so  uncertain  in  the 
issue  ;  but  true  it  is  that  they  hardly  ever  exceed  or  are  deficient  in 
the  number  required. 

"They  inoculate  indifferently  on  any  part  ;  but,  if  left  to  their 
choice,  they  prefer  the  outside  of  the  arm,  midway  between  the 
wrist  and  the  elbow  for  the  males  ;  and  the  same  between  the 
elbow  and  the  shoulder  for  the  females.  Previous  to  the  opera- 
tion, the  operator  takes  a  piece  of  cloth  in  his  hand  (which  becomes 
his  perquisite  if  the  family  is  opulent),  and  with  it  gives  a  dry 
friction  upon  the  part  intended  for  inoculation  for  the  space  of 
eight  or  ten  minutes,  then  with  a  small  instrument  he  wounds, 
b}'  many  slight  touches,  about  the  compass  of  a  silver  groat, 
just  making  the  smallest  appearance  of  blood ;  then  opening  a 
linen  double  rag  (which  he  always  keeps  in  a  cloth  round  his 
waist),  he  takes  from  thence  a  small  pledgit  of  cotton  charged  with 
the  variolous  matter,  which  he  moistens  with  two  or  three  drops  of 
the  Ganges  water,  and  applies  it  to  the  wound,  fixing  it  on  with  a 
slight  bandage,  and  ordering  it  to  remain  on  for  six  hours  without 
being  moved  ;  then  the  bandage  to  be  taken  off,  and  the  pledgit  to 
remain  until  it  falls  off  itself 

"The  cotton  which  he  preserves  in  a  double  callico  rag  is  satu- 
rated with  matter  from  the  inoculated  pustules  of  the  preceding  year ; 
for  they  never  inoculate  with  fresh  matter,  nor  with  matter  from  the 
disease  caught  in  the  natural  way,  however  distinct  and  mild  the 
species.  .  .  .  Early  on  the  morning  succeeding  the  operation,  four 
collons  (an  earthen  pot  containing  about  two  gallons)  of  cold  water 
are  ordered  to  be  thrown  over  the  patient,  from  the  head  down- 
wards, and  to  be  repeated  every  morning  and  evening  until  the 
fever  comes  on  (which  usually  is  about  the  close  of  the  sixth  day 
from  the  inoculation),  then  to  desist  until  the  appearance  of  the 
eruptions  (which  commonly  happens  at  the  close  of  the  third  com- 
plete day  from  the  commencement  of  the  fever),  and  then  to  pursue 
the  cold  bathing  as  before  through  the  course  of  the  disease,  and 


i-^  SAIALL  POX  INOCULATION. 


until  the  scabs  of  the  pustules  drop  off.     They  are  ordered  to  open 
all  the  pustules  with  a  fine  sharp-pointed  thorn  as  soon  as  they 
begin  to  change  their  colour,  and  whilst  the  matter  continues  in  a 
fluid  state.     Confinement  to  the  house  is  absolutely  forbid,  and  the 
inoculated  are  ordered  to  be  exposed  to  every  air  that  blows  ;  and 
the  utmost  indulgence  they  are  allowed  when  the  fever  comes  on, 
is  to  be  laid  upon  a  mat  at  the  door  ;  but,  in  fact,  the  eruptive 
fever  is  generally  so  inconsiderable  and  trifling  as  very  seldom  to 
require  this  indulgence.     Their  regimen  is  ordered  to  consist  of 
all  the  refrigerating  things   the    climate  and   season  produce,  as 
plantains,  sugar-canes,  water-melons,  rice,  gruel  made   of  white 
poppy-seeds  and  cold  water,  or  thin  rice  gruel  for  their  ordinary 
drink.     These  instructions  being  given,  and  an  injunction  laid  on 
the  patients  to  make  a  thanksgiving  Poojah,   or   offering  to  the 
goddess  on  their  recovery,  the  operator  takes  his  fee,  which  from 
the  poor  is  a  pund  of  cowries,  equal  to  about  a  penny  sterling,  and 
goes  on  to  another  door  down  one  side  of  the  street,  and  up  on  the 
other  ;  and  is  thus  employed  from  morning  till  night,  inoculating 
sometimes  eight  or  ten  in  a  house." 

In  China. — D'Entrecolles^  ascertained  from  a 
medical  work  in  Pekin,  that  inoculation  encountered 
strong  opposition  in  China.  The  author  of  the  book 
is  said  to  have  lived  in  the  latter  part  of  the  dynasty 
of  Ming ;  hence  Woodville  concluded  that  inocu- 
lation in  China  had  not  been  practised  two  hundred 
years."-^  In  India,  on  the  other  hand,  it  seems  from 
tradition  to  have  been  a  custom  from  time  immemorial. 
The  methods  employed  in  the  two  countries  were 
so  entirely  different,  that  it  is  scarcely  probable  that 
they    derived    their    information    at    the    same    time    or 

'  \y¥.r\\.rer,o\\cs,  Leiires  £f^i/.  ct  Curieiiscs,^.   lo.     1718. 
■  Woodville,  he  cit.,  p.  54. 


FOREIGN  COUNTRIES.  15 

from  the  same  source.  The  Chinese,  who  called  it 
sowing  the  Small  Pox,  took  from  two  to  four  dried 
pustules  or  scales,  between  which  they  placed  a  small 
portion  of  musk.  The  scales  were  kept  in  a  jar 
for  several  years  ;  but  if  it  were  necessary  to  resort 
to  recent  pustules,  it  was  thought  advisable  to 
correct  the  "acrimony  of  the  matter"  by  exposing  it 
to  the  steam  of  an  infusion  of  the  roots  of  scorzonera 
and  liquorice.  Sometimes  they  employed  scales  which 
had  been  dried,  powdered,  and  made  into  a  paste. 
The  whole  was  wrapped  up  in  cotton  and  introduced 
into  the  patient's  nostril.  Woodville  pointed  out  that 
this  method  probably  accounted  tor  the  want  of  success 
in  China,  for  if  the  matter  produced  the  same  result 
as  inoculation,  a  troublesome  inflammation  of  the 
Schneiderian  membrane  ensued,  and  if  this  did  not 
take  place,  the  variolous  effluvia  being  inhaled  into 
the    lungs,  would    produce    the    natural    Small    Pox. 

In  France.  —  According  to  tradition,  inoculation 
had  long  been  practised  by  the  peasants  in  different 
parts  of  France,  but  more  especially  in  Auvergne  and 
Perigord.  Dr.  Boyer,  who  wrote  in  171 7,  was  the 
first  writer  who  noticed  inoculation.  Six  years  after- 
wards, the  success  of  inoculation  in  England  was 
published  in  Paris  by  Dr.  de  la  Costey  and  the  result 
was  a  declaration  by  the  principal  doctors  of  the 
Sorbonne,  that,  for  the  benefit  of  the  public,  it  was 
lawful    to  make    trials    of  this    practice.       Shortly  atter 


1 6  SMALL  POX  INOCULATION. 

this,  Dr.  Hecquet  published  a  thesis  entitled  Raisons 
de  doute  contre  r inoculation,  and  this,  together  with 
the  reports  of  the  failures  in  Boston,  U.S.A.,  and 
the  great  mortality  of  the  natural  Small  Pox  in 
London,  which  was  attributed  to  the  new  practice, 
soon  brought  inoculation  into  disrepute  in  France, 
and  the  proposed  experiments  were  abandoned.  In 
1752,  attention  was  again  paid  to  this  subject,  owing 
to  a  publication  of  Dr.  Butini  of  Montpelier,  and  two 
years  later,  M.  de  la  Condamine  read  a  paper  on  the 
advantages  of  inoculation  before  the  Royal  Academy 
of  Sciences  in  Paris  ;  but  it  was  not  until  1755  that 
the  practice  was  really  introduced  into  France.  M. 
Turgot  inoculated  a  child  four  years  old,  and 
M.  Chastellux,  aged  twenty-one,  also  submitted  to 
the  operation.  Dr.  Hosty,  who,  at  the  request  of  the 
French  Minister,  had  been  attending  the  Sm.all  Pox 
and  Inoculation  Hospitals  in  London,  on  his  return 
reported  favourably  of  inoculation,  and  this  report  had 
immense  effect  in  promoting  it  in  France.  In  1756, 
the  family  of  the  Duke  of  Orleans,  and  very  many 
persons  of  high  rank,  were  inoculated  by  different 
physicians,  and  in  1758,  the  practice  was  introduced  ' 
into  most  of  the  large  towns.  In  1760,  Angelo  Gatti  i 
settled  in  Paris.  His  patients  had  so  few  pustules 
that  it  was  said  that  he  diluted  the  virus.  Reports  ; 
of  failures  excited  general  alarm,  and  led  to  a  violent  |i 
controversy.     A   very    fatal    outbreak   of  Small   Pox    in 


FOREIGN  COUNTRIES.  17 

Paris,  in  1763,  was  attributed  partly  to  inoculation,  and 
the  practice  was  prohibited.  In  1768,  the  faculties  of 
physic  and  theology  decided  that  it  ought  to  be  per- 
mitted, and  it  was  again  resorted  to  in  the  provinces 
as   well   as    in    the  principal   towns. 

In  Spain. — Inoculation  was  not  extensively  adopted 
until  I  771,  although  it  had  been  introduced  there  forty- 
two  years  previously.  Dr.  Miguel  Gorman  came 
to  England  to  learn  the  Suttonian  method,  and 
returned  to  Madrid  in  1772,  where  he  operated  on 
the   nobility,   and   gave   great   satisfaction. 

In    Italy.  —  According    to     M.     de    la    Condamine, 

inoculation   had    been  secretly   practised   by   the    people 

of    Naples    from     time    immemorial  ;  1  it    was     reported 

that     nurses     often     inoculated     the     infants     entrusted 

to   their   care,  without   the  knowledge   of  their  parents, 

usually   by   rubbing   the  palm    of  the   hand   with    'fluid 

variolous   mailer   recently    taken   from    a  ptLstule.'       It 

had   not   only  been  adopted    by  the    peasants,   but   was 

practised     by    the     Marchese     Buffalini.     '  During     the 

violent    outbreak     of    Small    Pox    in    1754,    inoculation 

was   introduced    into    Rome  by   Peverini.      Considerable 

opposition     was     encountered,     but,     in     1755,     M.     de 

la     Condamine      was     in     Rome,     and     succeeded      in 

overcoming      this,     and,     in     about      t  tn    years,     the 

practice  was  established    in    nearly   all    the   large  towns 

in    Italy. 

In   Germany   and    Austria. — Inoculation  was  first 
VOL.   I.  2 


SMALL  POX  INOCULATION. 


performed    in    Hanover    in    1724.     Mr.   Maitland   oper- 
ated   on   H.R.H.   Prince  Frederick,   and  afterwards    onj 
eight  children  of  a  baron.     These  cases  were  success- 
ful, and  led  to   the  establishment  of  the  practice  in  that 
kingdom.       It   was  not   generally    adopted    in   Germany 
and     Austria,    owing    to     the    opposition    of    Haen    of 
Vienna,    although    his    publication     was     answered     by 
Condamine,    Tissot,    and,    later,    by    Tralles.       But    in 
1768,  some  of  the    Imperial  family  were   inoculated   by 
Dr.   Ingenhousz,  and    shortly  afterwards  an   Inoculation 
House    was    established    in    Vienna    by    the    Emperor. 
In    Berlin,  the    practice   was    soon    discountenanced,    for 
Meckel    inoculated    his    children,   and  on    repeating  the 
experiment  on  others  had  three  deaths,  two  being  in  the 
family  of  a  baron.      Dr.  Muzell  inoculated  six  children, 
of  whom  three  died,  and  the  three  who  recovered  were 
much    disfigured.       In     1774,     Dr.     Baylies     inoculated 
seventeen    persons ;     one     death     occurred,     which,     in 
order^  to  silence  an   unfavourable  report,  was  attributed 
to    a    "  putrid   tever,    of  which    the    eruption    was    only 
symptomatic."       In    1775,    inoculation    was    encouraged 
by    Royalty,    and    physicians    from    the    provinces    were 
summoned   to    Berlin    to   be   instructed   by    Dr.    Baylies. 
P)Ut    as    no    one    would    submit    to    the    operation,    his 
Majesty    was    obliged     to    utilise    the    children     in    the 
orphan    houses. 

In  Holland. ^Inoculation  was  introduced,  in  1748,  by 
Dr.  Tronchin,  who  first  operated  on  one  of  his  sons,  and 


FOREIGN  COUNTRIES.  ig 

then  on  a  number  of  persons,  including  some  of  high 
rank.  Divines  and  physicians  recommended  inocula- 
tion, but  it  was  not  very  generally  adopted  until  1746, 
when   Morand  and  others  practised  it  at  Amsterdam. 

In  Denmark. — A  countess  was  inoculated  in  1754, 
and  in  1758,  two  Inoculation  Houses  were  established 
by  the  King,  at  Copenhagen,  and  in  1760  the  Royal 
Prince  was   inoculated   with   success. 

In  Sweden. — The  first  trial  was  made  in  1754. 
It  made  rapid  progress  in  this  country,  for  Dr.  Schulz, 
a  pupil  of  Dr.  Archer,  gave  such  a  favourable  report 
of  the  practice  in  London,  that  several  Inoculation 
Houses   were  established. 

In  Switzerland. — Inoculation  was  introduced  into 
Switzerland  from  Geneva,  where  it  was  first  em- 
ployed in  1 75 1.  In  this  country  it  was  first  performed 
in  Lausanne  by  a  lady  who  inoculated  her  own  child, 
and  this  encouraged  many  to   follow  her  example. 

In  Russia. — Inoculation  was  reported  to  have  been 
practised  at  an  early  date  in  parts  of  the  Russian 
Empire,  but  it  was  unknown  at  St.  Petersburg  in 
1768,  when  it  was  introduced  there  and  at  Moscow 
by  Dimsdale,  who  had  been  summoned  to  St. 
Petersburg  to  inoculate  the  Empress.  Further  details 
of  Dimsdale's  practice  in  Russia  will  be  found  in  the 
description  of  the  method  of  inoculation  which  he 
employed.^ 

'    l^ide  p.  71. 


20  SMALL  POX  INOCULATION. 


In  America. — In  1721,  Small  Pox  visited  this 
country  after  an  absence  of  nineteen  years.  The 
Rev.  Cotton  Mather  copied  the  accounts  of  inocula- 
tion o-iven  by  Tinioni  and  Pylarini  in  the  Philosophical 
Transactions  of  the  Royal  Society,  and  sent  them  to 
the  practitioners  of  Boston.  Dr.  Zabdiel  Boylston^ 
was  induced  to  inoculate  his  child,  and  two  of  his 
negro  servants,  and  in  six  months  he  had  inoculated 
244  persons. 

It  may  be  interesting  to  note  that  out  of  these 
244  cases,  in  six  there  was  no  effect  at  all,  and  six 
died  in  consequence  of  the  inoculation,  but  the  deaths 
were  attributed  to  other  causes. 

"  And  as  to  those  who  died  under  Inoculation,  I  would  observe 
that  Mrs.  Doxwell,  we  have  great  reason  to  believe,  was  infected 
before.  Mr.  White  thro'  splenetic  delusions,  died  rather  from 
abstinence  than  the  Small  Pox.  Mrs.  Scarborough  and  the 
Indian  girl  died  of  accidents  by  taking  cold.  Mrs.  Wells  and 
Searle  were  persons  worn  out  with  Age  and  Diseases,  and  very 
likely  these  two  were  infected  before." 

The  true  explanation  is  to  be  found  in  the  method 
which  Boylston  not  only  employed  in  his  own  cases, 
but  also  recommended  to  other  inoculators. 

"  Take  your  Medicine  or  Pus  from  the  ripe  pustules  of  the 
Small  Pox  of  the  distinct  kind,  either  from  those  in  the  natural 
way,  or  from  the  inoculated  sort,  provided  the  person  be  other- 
wise  healthy  and  the  matter  good.  .   .  . 

•Boylston,  An  Historical  Account  of  the  Small  Pox  inoculated 
in  New  E7igla7id  upon  all  Sorts  of  Persons,  Whites,  Blacks,  and 
of  all  Ages  and  Constitutions.     1726. 


I 


FOREIGN  COUNTRIES.  21 


"  My  way  of  taking  it  is  thus  :  Take  a  fine  cut,  sharp  tooth- 
pick (which  will  not  put  the  person  in  any  fear,  as  a  Lancet 
will  do  many),  and  open  the  Pock  on  one  side,  and  press  the 
Boil,  and  scoop  the  matter  on  your  quill,  and  so  on." 

Boylston's  experiments,  and  particuhirly  his  fatal 
cases,  excited  a  great  deal  of  opposition  to  inoculation, 
and  many  pamphlets  were  published  both  in  defence  of, 
and  against,  the  practice.  But  the  following  manifesto 
gave  a   severe   check  to   his   operations  : — 

^^  At  a  meeting  by  Public  Authority  in  the  Town-Jiouse  of  Boston, 
before  His  Majesty's  Justices  of  the  Peace  and  the  Select-Men; 
the  Practitioners  of  Physick  and  Surgery  being  called  before  them 
concerning  Inoculation,  agreed  to  the  following  conclusion  : — 

"  A  Resolve  upon  a  Debate  held  by  the  Physicians  of  Boston^ 
concerning  Inoculating  the  Small  Pox,  on  the  twenty  first  day 
o^  July,  1 72 1.  It  appears  by  numerous  Instances,  That  it  has 
prov'd  the  Death  of  many  Persons  soon  after  the  Operation, 
and  brought  Distempers  upon  many  others,  which  have  in  the 
End   prov'd    fatal  to  'em. 

"That  the  natural  tendency  of  infusing  such  malignant  Filth 
in  the  Mass  of  Blood,  is  to  corrupt  and  putrify  it,  and  if  there 
be  not  a  sufficient  Discharge  of  that  Malignity  by  the  Place 
of  Incision  or  elsewhere,  it  lays  a  Foundation  for  many 
dangerous  Diseases. 

"  That  the  Operation  tends  to  spread  and  continue  the 
Infection  in  a  Place  longer  than  it  might  otherwise  be. 

"That  the  continuing  the  Operation  among  us  is  likely  to 
prove  of  most  dangerous  Consequence. 

'^  By  the  Select-Men  of  the   Town   of  Boston,  July  2 2d. 

"  The  Number  of  Persons,  Men,  Women,  and  Children,  that 
have  died  of  the  Small  Pox  at  Boston,  from  the  middle  of 
April  last  (being  brought  here  then  by  the  Saltertuda' s  Fleet) 
to  the  23rd  of  this  instant  July  (being  the  hottest  and  the 
worst  Season  of  the  Year  to  have  any  Distemper  in),  are,  viz., 


22  SMALL  POX  INOCULATION. 

2  Men  Strangers,  3  men,  3  Young  Men,  2  Women,  4  Children, 
I  Negro  Man,  i  Negro  Woman,  and  i  Indian  Woman,  17  in 
all  ;  of  those  that  have  had  it,  some  are  well  recovered,  and 
others  in  a  hopeful  and  fair  Way  of  Recovery." 

Boylston  expressed  his  disapproval  of  this  report 
upon  the  cases  of  natural   Small   Pox. 

"  It  is  a  thousand  pities  our  Select-Men  made  so  slight  and 
trifling  a  Representation  of  the  Small  Pox,  that  had  always 
prov'd  so  fatal  in  New  England^  as  they  seem  to  have  done 
in  this  Advertisement." 

It  would  appear  from  this,  that  in  order  to  make 
converts  to  inoculation,  it  was  necessary  to  keep  alarm- 
ing accounts  of  the  natural  Small  Pox,  before  the  eyes 
of  the   public. 

In  1764,  Small  Pox  again  visited  Boston,  and 
three  thousand  persons  were  inoculated  successfully; 
and  this  result  was  attributed  to  the  administration  of 
mercurials  and  antimony  in  the  course  of  treatment 
preparatory  to  the  operation. 

On  the  other  hand,  Inoculation  was  so  unsuccess- 
ful in  Philadelphia,  that,  in  1750,  there  was  a  strong 
feeling  in  favour  of  abandoning  it. 

During  the  temporary  decline  of  Inoculation  In 
England,  it  was  progressing  rapidly  in  South  America. 
A  Carmelite  missionary  near  the  Portuguese  colony 
of  Para  inoculated  the  Indians,  who  were  being  carried 
off  in  large  numbers  by  the  Small  Pox,  in  1728  and 
1729;    another    missionary    on    the    banks    of   the    Rio 


FOREIGN  COUNTRIES.  •     23 

Niger  and  some  Portuguese  inhabitants  followed  his 
example, 
//^In  1738,  Small  Pox  was  imported  into  South 
Carolina  by  a  cargo  of  slaves  from  Africa,  and  Mr, 
Mowbray,  a  surgeon,  introduced  Inoculation,  He  was 
followed  by  Dr,  Kirkpatrick  and  others,  so  that  before 
long,  about  a  thousand  persons  were  inoculated,  eight 
of  whom  died  in  consequence.  These  fatal  cases  were 
subsequently  alluded  to  by  Dr.  Kirkpatrick,^  but  the 
account  is  of  little  value,  for,  as  Dr,  Woodville  says, 
"  from  the  very  defective  statement  given  of  the  eight 
unsuccessful  cases,  the  reader  is  unable  to  profit  by  a 
recital  of  them."  In  the  island  of  St,  Christopher,  a 
planter  inoculated  three  hundred  of  his  slaves  without 
a  sino-le  loss, 

^  Kirkpatrick,  Essay  on  hiociclatioji,     1743- 


CHAPTER  II. 

HISTORY  OF  INOCULATION  IN   GREAT  BRITAIN  AND 

IRELAND.     ■ 

In  Wales. — When  the  Eastern  method  of  pre- 
venting Small  Pox  was  introduced  into  London,  and 
especially  when  members  of  the  Royal  family  were 
inoculated,  this  subject  became  a  topic  of  general  con- 
versation ;  the  news  spread  into  the  country,  and  it 
then  became  known  that  a  similar  practice  had  long 
been  employed  in  South  Wales.  As  in  the  East,  it 
was  called  buying  the  Sjnall  Pox.  In  Pembrokeshire, 
according  to  Dr.  Perrot  Williams,^  the  inhabitants  had 
carried   on   this   custom   from   time  immemorial. 

"  In  order  to  procure  the  distemper  to  themselves,  they  rub  the 
matter  taken  from  the  pustules,  when  ripe,  on  several  parts  of  the 
skin  of  the  arms,  etc.,  or  prick  those  parts  with  pins  or  the  like,  first 
infected  with  the  same  matter.  And  notwithstanding  they  omit 
the  necessary  evacuations,  such  as  purging,  etc.,  yet,  as  I  am 
inform'd,  they  generally  come  off  well  enough  ;  and  what's 
remarkable,  1  cannot  hear  of  one  instance  of  their  having  the 
Small  Pox  a  second  time. 

"  A  learned  and  very  ingenious  gentleman  of  this  country  told 
me  not  long  since  that  about  twenty  years  ago,  when  at  school, 

'  Williams,  P/iil.  Trans.,  1722,  p.  263. 


GREAT  BRITAIN  AND  IRELAND.  25 

he  and  several  of  his  schoolfellows  (how  many  I  don't  exactly 
remember)  infected  themselves  at  the  same  time,  from  the  same 
person,  and  that  not  one  of  them  miscarry'd,  though  he  had  more 
of  the  Small  Pox  than  he  designed.  .   .  . 

"  He  solemnly  declares  that,  having  when  at  school,  as  I  formerly 
said,  rubb'd  the  skin  off  his  left  hand,  where  the  scar  is  now  very 
visible,  with  the  back  edge  of  his  penknife,  till  the  btood  began  to 
appear,  he  apply'd  the  variolous  matter  to  that  part.  .   .  . 

"  There  are  now  living  in  this  Town  [Haverford  West]  and 
neighbourhood  five  or  six  persons,  who  undoubtedly  had  that 
distemper  after  taking  the  foresaid  method  to  infect  themselves  : 
one  of  whom,  a  young  woman  aged  twenty-three,  told  me  (since  I 
received  your  letter)  that,  about  eight  or  nine  years  ago,  in  order 
to  infect  herself,  she  held  twenty  pocky  scabs  (taken  from  one 
toward  the  latter  end  of  the  distemper)  in  the  hollow  of  her  hand 
a  considerable  time ;  that  about  ten  or  twelve  days  afterwards  she 
sicken'd,  and  had  upwards  of  thirty  large  pustules  in  her  Face 
and  other  parts  ;  and  that  she  has  since  freely  conversed  with 
such  as  have  had   the  Small  Pox  on  them." 

Mr.  Wright/  surgeon,  of  Haverford  West,  also  gave 
a  description  of  buying  the  Small  Pox  in  a  letter  to 
Mr.  Sylvanus   Bevan,  an  apothecary   in  London  : — 

"  I  received  yours  the  9th  instant,  and  in  answer  to  it  will  readily 
give  you  all  the  satisfaction  I  can,  in  relation  to  a  very  antient 
custom  in  this  country;  commonly  called  buying  the  Small  Pox, 
which,  upon  a  strict  inquiry,  since  I  had  your  letter,  I  find  to  be  a 
common  practice,  and  of  very  long  standing ;  being  assured  by 
persons  of  unquestionable  veracity,  and  of  advanced  age,  that 
they  have  had  the  Small  Pox  communicated  to  themselves  this 
way,^  when  about  sixteen  or  seventeen  years  of  age,  they  then 
being  very  capable  of  distinguishing  that  distemper  from  any 
other ;  and  that  they  have  parted  with  the  matter  contained  in  the 
pustules  to  others,  producing  the  same  effects.     There  arc  two  large 

'  Wright,  Phi/.  Trans.,  1722,  p.  267. 


26  SMALL  POX  INOCULATION. 

villages  in  this  county  near  the  harbour  of  Milford  more  famous 
for  this  custom  than  any  other,  namely,  St.  Ishmaels  and  Marloes. 
The  old  inhabitants  of  those  villages,  with  which  they  abound, 
being  in  a  healthful  situation,  say  that  it  has  been  a  common 
practice  with  them  time  out  of  mind  ;  and  what  was  more  remark- 
able, one,  IVilliam  Allen  of  St.  Ishmaels,  ninety  years  of  age  (who 
died  about  six  months  ago  or  thereabouts),  declared  to  some 
persons  of  good  sense  and  integrity,  that  this  practice  was  used 
all  his  time  ;  that  he  very  well  remembered  his  mother's  telling 
him,  that  it  v/as  a  common  practice  all  her  time,  and  that  she  got 
the  Small  Pox  that  way.  These,  together  with  the  many  other 
informations  I  have  met  with  from  almost  all  parts  of  the  county, 
confirm  me  in  the  belief  of  its  being  a  very  antient  and  frequent 
practice  among  the  common  people ;  and  to  prove  that  this 
method  is  still  continued  among  us,  I  will  give  you  the  relation  of 
an  elderly  woman,  a  midwife,  who  accidentally  came  into  com- 
pany when  your  letter  was  reading,  whose  name  is  Joan  Jones, 
aged  seventy  years,  of  good  credit  and  perfect  memory.  She 
solemnly  declares  that  about  fifty-four  3^ears  ago,  having  then  the 
Small  Pox,  one  Margaret  Broiun,  to  the  best  of  her  remembrance 
then  about  twelve  or  thirteen  years  of  age,  bought  the  Small  Pox 
of  her ;  that  the  said  Margaret  Brown  was  seized  with  the  Small 
Pox  a  few  days  afterwards  ;  that  the  said  Margaret  Broivn  had 
not  had  the  Small  Pox  a  second  time  a  twelvemonth  ago,  and  she 
verily  believes  that  she  had  not  had  them  since.  She  farther  says 
that  she  has  known  this  way  of  procuring  the  Small  Pox  practised 
from  time  to  time  above  fifty  years  ;  that  it  has  been  lately  used 
in  her  neighbourhood,  and  she  knows  but  of  one  dying  of  the 
said  distemper  when  communicated  after  the  method  aforesaid, 
which  accident  happened  within  these  two  years  last  past ;  the 
person  who  miscarried  (a  young  woman  about  twenty  years  of 
age)  having  procured  the  distemper  from  a  man  then  dying  of  a 
very  malignant  Small  Pox.  The  above  relation  I  heard  the  old 
woman  declare  two  days  ago,  and  she  was  willing  to  take  her 
oath  of  it  before  Dr.  Williams,  who  is  a  magistrate.  As  to  what 
you  mention  concerning  the  manner  of  communicating  the  infec- 
tious matter  to  the  blood,  by  scraping  the  skin  thin  with  a 
penknife  and  so  rubbing  in  the  matter,  that  was  only  the  case  of 


GREAT  BRITAIN  AND  IRELAND. 


one  particular  gentleman,  Mr.  Owen,  a  counsellor  at  Law,  whom  I 
heard  several  times  positively  affirm  that  he  bought  the  Small 
Pox  when  at  school,  and  of  such  a  Lady,  now  living,  and  gave  her 
threepence  for  the  Matter  contained  in  twelve  pustules.  That 
hundreds  in  this  country  have  had  the  Small  Pox  this  way  is 
certain  ;  and  it  cannot  produce  one  single  instance  of  their  ever 
having  them  a  second  time." 

In  Scotland. — In  the  Highlands  of  Scothmd,  where, 
according  to  Kennedy  ^  and  Munro,^  Small  Pox 
inoculation  was  early  employed,  the  disease  was  induced 
by  a  method  somewhat  similar  to  that  of  holding  vario- 
lous scabs  in  the  hand  ;  worsted  threads  charged  with 
variolous  matter  being  tied  round  the  wrists. 

"  When  Small  Pox  appears  favourable  in  one  child  of  a  family, 
the  parents  generally  allow  commerce  of  their  other  children  with 
the  one  in  the  disease  ;  nay,  I  am  assured  that  in  some  of  the 
remote  Highland  parts  of  this  country,  it  has  been  an  old  practice 
of  parents  whose  children  have  not  had  the  Small  Pox  to  watch 
for  an  opportunity  of  any  child  of  their  neighbours  being  in  good 
mild  Small  Pox,  that  they  may  communicate  the  disease  to  their 
own  children  by  making  them  bedfellows  to  those  in  it,  and  by 
tying  worsted  threads  wet  with  the  pocky  matter  round  their 
wrists." 

In  the  island  of  St.  Kilda,  Small  Pox  was  com- 
municated by  rubbing  the  variolous  matter  upon  the 
skin  of  the  elbow  joint. 

Inoculation  was  not  practised  by  surgeons  in 
Scotland  until  1726,  when  Mr.  Maitland  performed  this 
operation   upon  ten  persons  ;   but  as  one  of  these  cases 

'  Kennedy,  loc.  cit.,  p.  157.     17 15. 

-  Monro,  Observations  o?i  the  Differ'ent  Kinds  o/Sma/l Pox,  p.  54.   1 8 1 8. 


28  SMALL   POX  INOCULATLON. 

proved  fatal,  such  a  prejudice  was  excited  that 
twenty  years  elapsed  before  an  attempt  was  made  to 
revive  the  practice.  At  Dumfries,  where  they  had 
suffered  very  greatly  from  Small  Pox,  inoculation 
was  Introduced  in  1733,  but  In  other  parts  of  North 
Britain  It  was  not  adopted  until   1753. 

In  Ireland. — Inoculation  was  first  performed  at 
Dublin  In  1723.  In  this  and  in  the  three  following 
years,  twenty-five  subjects  were  inoculated,  and  as 
three  out  of  this  number  died,  the  results  were  not 
very  encouraging.  Two  of  these  deaths  occurred  in 
one  family,  in  which  five  children  had  been  inoculated. 

The  history  of  these  cases  was  published  by  Dr. 
Bryan  Robinson,  and  as  they  well  illustrate  a  very 
common  result  of  Inoculation  at  this  period,  it  will  not 
be  without  interest  to  produce  his  account   In   full. 

"  Various  Reports  having  been  spread  concerning  five  Children, 
upon  whom  the  Small  Pox  was  inoculated,  I  have  been  desired 
to  pubnsh  the  true  Account  of  their  Case ;  which  is  as 
follows.* 

"  A  Gentleman  had  six  Children,  five  Sons  and  a  Daughter ; 
who  from  their  Infancy  had  been  kept  to  a  regular  cooling  Diet, 
and  had  scarcely  tasted  Flesh-meat  'till  about  a  Year  ago,  and 
since  that  time,  eat  only  such  as  was  of  easy  Digestion,  and 
that    sparingly    once    a    Day.       The    fourth    Son,    aged    between 


*  "  I  was  a  Stranger  to  the  Children,  and  was  not  consulted  about  them 
'till  the  eleventh  Morning-  after  their  Inoculation ;  and  therefore  am 
obliged  to  their  Parents,  and  those  who  attended  them,  for  what  relates 
to  their  Diet,  their  Constitutions,  the  Manner  of  their  being  prepared 
for  the  Disease,  and  the  Effects  produced  by  the  Inoculation  before  I 
saw  them. 


GREAT  BRITAIN  AND  IRELAND.  29 

nine  and  ten  Years,  of  a  healthy  Constitution,  took  the  Small 
Pox  in  the  natural  Way  on  the  i8th  of  August,  1725.  His 
Pock  being  distinct  and  good,  the  Parents  resolved  to  have  the 
rest  of  their  Children  inoculated  from  him  ;  which  was  accordingly 
done  on  the  26th  of  August,  the  ninth  Day  of  their  Brother's 
Illness.  They  were  each  of  them  prepared  for  the  Distemper 
by  two  Doses  of  a  purging  Infusion,  one  of  which  was  given 
on  the  2 1  St,  and  the  other  on  the  23rd.  From  the  time  of 
Inoculation,  they  were  kept  from  Flesh-meat,  and  were  only 
allow'd  Bread  and  Milk,  Bread  and  Butter,  light  Pudding,  Tea 
with  Milk,  and  things  of  that  Nature. 

"I.  The  eldest  Son  aged  thirteen  Years  was  nursed  in  the 
Country,  where  he  continued  'till  he  was  a  Year  and  a  half  old, 
and  was  then  brought  home  to  his  Parents  in  a  very  poor  and 
weak  Condition.  Soon  after  he  grew  rickety,  but  recovered  from 
that  Disease  in  less  than  a  Year.  In  some  Months  after  his 
Recovery,  he  got  a  swelling  in  his  Foot  which  suppurated,  broke, 
and  ran  for  several  Weeks.  After  this  was  healed,  he  continued 
well  for  about  three  Years,  then  he  had  an  Abscess  in  his  Belly 
below  the  Navel,  which  suppurated,  broke  and  was  healed  in 
about  two  Months.  Since  that  time  he  enjoyed  a  very  good 
state  of  Health,  and  was  a  strong  lusty  Boy  when  he  was 
inoculated. 

"  On  the  eighth  Day  after  Inoculation,  he  began  to  be  dis- 
ordered with  a  Head-ach  and  Vomiting.  His  Vomiting  was 
frequent  and  violent  'till  the  third  Day  of  his  Illness,  and  then 
it  abated  but  did  not  cease,  for  he  vomited  at  times  'till  the 
fourth  Day  at  Noon.  No  Pock  appeared,  but  on  the  third,  at 
Night,  purple  Spots  of  different  sizes  were  observed  all  over  his 
Body,  many  of  which  were  as  large  in  Diameter  as  a  midling 
Pea.  About  this  time  he  fainted  ;  and  died  in  the  Evening  of 
the  fourth  Da}',  about  twenty-four  Hours  after  the  first  Appear- 
ance of  the  Spots.  He  was  extreamly  thirsty  during  his  Illness, 
and  for  the  most  part  pale  and  cold. 

"  His  Incision  had  a  good  Digestion  at  the  second  Dressing, 
which  was  on  the  third  Day  after  it  was  made,  and  continued 
in  this  State  till  the  Day  on  which  he  sickened  ;  then  it  grew 
pale,  flaccid,   and  had  little  or  no  Discharge.      It  continued  thus 


30  SMALL   POX  INOCULATION. 

'till  the  third  Day  of  his  Sickness  ;  then  it  turned  blackish, 
and  was  perfectly  dry  on  the  fourth,  the  Day  on  which  he 
died. 

"II.  The  second  Son  aged  eleven  Years  of  a  healthy  Con- 
stitution, began  to  be  disordered  on  the  Seventh,  at  Night.  He 
first  complained  of  a  Pain  in  his  Bones  and  Back,  and  the 
next  Morning  of  a  Pain  in  his  Head,  and  was  very  dozy  all 
that  Day.  On  the  third,  he  was  very  restless,  raved  much,  and 
had  a  very  uneasy  Night.  He  vomited  a  little  on  the  third  and 
fourth,  and  what  he  threw  up  was  blackish  and  mixed  with 
Clots  of  Blood.  The  Pock  began  to  appear  on  the  fourth  towards 
Night,  and  upon  the  Eruption  all  the  fore-mentioned  Symptoms 
vanished.  He  then  bled  two  or  three  Spoonfuls  from  his  Nose. 
On  the  fifth,  in  the  Morning  he  was  very  easy  and  without  a 
Fever.  On  the  sixth,  he  complained  of  a  sore  Throat,  began 
to  spit,  and  continued  spitting  three  or  four  Days.  His  Pock 
was  distinct,  ripened  well,  and  he  recovered. 

"  His  Incision  had  a  good  Digestion  on  the  third  Day  after 
Inoculation,  and  continued  to  make  a  good  Discharge  'till  he 
sickened ;  then  it  grew  pale  and  flaccid,  and  continued  so  'till 
the  seventh  Day  of  his  Sickness  :  From  the  seventh  to  the  ninth 
it  was  blackish,  and  somewhat  dry,  but  after  that  it  again  came 
to  a  good  Digestion. 

"  III.  The  third  Son  aged  about  ten  Years,  a  fresh  colour'd, 
strong,  healthy  Boy,  who  never  had  had  any  Sickness,  began 
to  be  disordered  on  the  eighth  Day  after  Inoculation ;  in  the 
Evening  he  complained  of  a  Pain  in  his  Head  and  Belly.  He 
was  very  hot,  thirsty  and  restless  all  that  Night.  The  next 
Day  which  was  the  second  of  his  Sickness,  he  vomited  in  the 
Morning  and  continued  vomiting  at  Times  'till  the  third  Day 
in  the  Evening.  Then  the  Eruption  began,  and  on  the  fourth, 
in  the  Morning,  it  appear'd  in  his  Face  like  an  Erysipelas.  I 
could  not  at  that  time  discover  any  Pustules  either  on  his  Body 
or  Limbs,  but  he  had  many  purple  Spots  all  over  him,  especially 
in  his  Neck  and  Loins,  many  of  which  were  as  large  in  Diameter 
as  a  great  Pin's  Head.  On  'the  fifth,  the  Pock  began  to  appear 
in  his  Body  and  Limbs,  and  came  out  thick  on  the  sixth.  He 
was  extreamly  restless,  and  raved  much  from  the  Beginning  of 


GREAT  BRITAIX  AND  IRELAND.  31 

the  Eruption  to  the  sixth  Day,  but  was  pretty  quiet  that  Night, 
slept  and  began  to  spit.  On  the  seventh,  his  Face  was  swell'd, 
his  Spitting  continued,  and  he  had  some  Sleep.  On  the  eighth, 
he  continued  much  in  the  same  state,  only  drank  and  slept 
more  than  he  had  done  before.  On  the  ninth,  in  the  morning, 
the  swelling  of  his  Face  abated.  On  the  eleventh,  his  Breath 
grew  short,  his  Spitting  stopt,  and  he  died  in  the  Evening.  His 
Pock  was  the  worst  sort  of  the  confluent  Kind,  it  never  fill'd  nor 
digested  ;  but  continued  flat  and  watery  'till  his  Death.  He  had 
no  Thirst,  and  wou'd  drink  but  little  during  his  Illness. 

"  His  Incision  discharged  a  well  digested  Matter  from  the  third 
Day  after  Inoculation  'till  the  Day  on  which  he  sickened  :  Then 
it  grew  pale,  flaccid,  and  had  little  or  no  Discharge.  It  continued 
thus  to  the  eighth  Day  of  his  Sickness,  then  it  turned  black  and 
was  scarified  :  On  the  ninth,  it  discharged  a  little  thin  Sanies  : 
It  grew  quite  dry  on  the  tenth,  the  Day  before  he  died. 

"  IV.  The  fifth  Son,  strong  and  healthy,  aged  about  eight 
Years,  began  to  be  disordered  on  the  seventh  at  Night  with  a 
feverish  Heat,  and  a  Pain  in  his  Head.  These  Symptoms 
continued  much  the  same  all  the  next  Day ;  but  towards  Evening 
the  Fever  encreased,  and  he  had  a  very  uneasy  Night ;  he  grew 
easier  the  following  Morning,  and  continued  so  'till  Evening, 
when  the  Small  Pox  appeared.  He  sweated  much  all  that  Day. 
His  Pock  was  distinct  and  good ;  he  had  but  few,  and  recovered 
without   any  ill  or  irregular  Symptoms. 

"  His  Incision  suffered  no  Change  at  the  time  of  his  Sickening, 
but  discharged  plentifully  throughout  the  Distemper. 

"  V.  The  Daughter  aged  six  Years,  of  a  pale  Complexion,  but 
always  healthy,  began  to  be  disordered  on  the  seventh  Day  after 
Inoculation :  Towards  Night  she  grew  hot  and  complained  of  a 
Pain  in  her  Head.  On  the  Day  following,  she  vomited  in  the 
Morning  ;  towards  Evening  her  Fever  encreased,  and  she  had 
a  very  restless  Night.  She  was  much  easier  the  third  Morning, 
and  continued  so  'till  Evening,  when  the  Pock  began  to  appear. 
She  dozed  all  the  fourth  Day,  had  a  Looseness,  and  vomited 
once  or  twice  ;  towards  Evening  were  observed  many  purple 
Spots,  especially  on  her  Neck  and  Breasts,  the  largest  of  which 
were  not  greater  in  diameter  than  a  midling  Pin's  Head.     She 


,32  SMALL  POX  INOCULATION. 

had  a  distinct  Pocla,  but  was  very  full,  especially  in  her  Face 
and  Limbs.  On  the  tenth,  she  had  some  loose  Stools,  two  or 
three  whereof  were  bloody.  The  Pock  fiU'd,  digested  well,  and 
she  recover' d. 

"  Her  incision  in  the  beginning  had  but  an  ill  digestion  :  from 
the  time  of  her  sickening  it  was  pale  and  flaccid  'till  the  eighth 
Day,  then  it  grew  blackish  and  was  scarified,  the  Slough  separated 
on  the  tenth,  and  after  that  it  had  a  good  Discharge." 

Inoculation  in  England. — The  profession  In 
England  v^^as  persuaded  to  adopt  variolous  inoculation 
by   Lady   Mary  W  ortley  Montagu.^ 

Kennedy,  in  his  account  of  inoculation  as  practised  in 
the  East,  had  rather  advised  against  its  introduction 
into  England.  The  accounts  by  Timoni  and  Pylarini. 
which  appeared  in  the  Transactions  of  the  Royal  Society, 
merely  described  the  method.  But  in  171 7,  Lady  Mary 
Wortley  Montagu,  whose  husband  was  ambassador  at 
the  Ottoman  Court,  wrote  a  letter  from  Adrianople  to  a 
friend,  Mrs.  S.  C.  (Miss  Sarah  Chiswell),  in  which  she 
expressed  her  determination  to  persuade  the  physicians 
in   London  to  resort  to  inoculation. 

"  Apropos  of  distempers,  I  am  going  to  tell  you  a  thing  that  I 
am  sure  will  make  3'ou  wish  yourself  here.  The  Small  Pox,  so 
fatal  and  so  general  amongst  us,  is  here  entirely  harmless  by  the 
invention  of  ingrafting,  which  is  the  term  they  give  it.  There 
is  a  set  of  old  women,  who  make  it  their  business  to  perform  the 
operation  every  autumn  in  the  month  of  September,  when  the  great 
heat  is   abated.     People  send   to   one  another   to  know  if  any  of 


^Letters  a7id  Works  of  Lady  Alary   Wortley  Montagu,  vol.  i.,  p.  li 
New  Edition.     1887. 


GREAT  BRITAIN  AND  IRELAND.  i2> 

their  family  has   a   mind   to   have    the    Small  Pox.     They  make 

parties   for    this    purpose,    and  when    they   are   met   (commonly 

fifteen  or  sixteen  together),  the  old  woman  comes  with  a  nutshell 

full  of  the  matter  of  the  best  sort  of  Small  Pox,   and  asks  what 

veins  you  please   to   have  opened.     She   immediately  rips   open 

that  you   offer  to  her  with  a  large  needle  (which  gives  you   no 

more  pain  than  a   common  scratch),   and   puts   into   the  vein  as 

much   venom  as   can   lie  upon   the  head  of  her  needle,  and  after 

binds  up  the  little  wound  with  a  hollow  bit  of  shell ;  and  in  this 

manner  opens  four  or  five  veins.     The  Grecians  have  commonly 

the   superstition   of  opening  one  in  the   middle  of  the   forehead, 

in  each  arm,  and  on  the  breast,  to  mark  the  sign  of  the  cross; 

but  this  has  a  very  ill  effect,  all  these  wounds  leaving  little  scars, 

and  is  not  done  by  those  that  are  not  superstitious,  who  choose 

to  have  them  in  the  legs,  or  that  part  of  the  arm  that  is  concealed. 

The  children  or  young  patients  play  together  all  the  rest  of  the 

day,  and  are  in  perfect  health  to  the  eighth.    Then  the  fever  begins 

to  seize  them,  and  they  keep  their  beds  two  days,  very  seldom  three. 

They  have  very  rarely  above  twenty  or  thirty  in  their  faces,  which 

never  mark ;  and  in  eight  days'  time  they  are  as  well  as  before  their 

illness.     Where  they  are   wounded,   there  remain    running  sores 

during  the  distemper,  which   I   don't  doubt  is  a  great  relief  to  it. 

Every  year  thousands  undergo    this   operation ;  and   the    French 

Ambassador  says  pleasantly  that  they  take  the  Small  Pox  here  by 

way  of  diversion,  as  they  take  the  waters  in  other  countries.   There 

is  no  example  of  any  one  that  has  died  in  it,  and  you  may  believe 

I  am   very   well   satisfied  of  the  safety  of  the  experiment,  since 

1    intend  to   try  it  on   my  dear  Httle  son.      I   am   patriot  enough 

to  take  pains  to  bring  this  useful  invention  into  fashion  in  England  ; 

and    I   should    not    fail    to   write   to    some   of  our  doctors   very 

particularly  about  it,  if  I  knew  any  one  of  them  that  I  thought 

had  virtue  enough   to  destroy  such  a  considerable  branch  of  their 

revenue  for   the   good  of   mankind.       But   that  distemper  is  too 

beneficial  to  them  not  to  expose  to  all  their  resentment  the  hardy 

wight  that  should  undertake  to  put  an  end  to  it.     Perhaps  if  I  live 

to   return,    I   may,   however,    have    courage    to    war  with    them. 

Upon    this    occasion    admire    the    heroism    in   the    heart   of  your 

friend." 

VOL.   I.  3 


34  SMALL   POX  LNOCULATION. 

Lady  Mary  Wortley  Montagu  accordingly  desired  Mr. 
Maitland,  surgeon  to  the  Embassy,  to  procure  vario- 
lous matter  from  a  suitable  subject,  and  an  old  Greek 
woman,  many  years  in  the  habit  of  inoculating,  was 
employed  to  insert  it.  The  woman  inoculated  one  arm, 
and  Maitland  the  other  ;  the  disease  ensued  in  due 
course,  with  an  eruption  of  about  one  hundred  pustules. 
This  took  place  in  March  171 7,  and  was  the  first  time 
that  the  Byzantine  method  of  inoculation  was  performed 
on  an  English  subject  ;  but  this  method  was  not  em- 
ployed in  England  until  the  year  1721,  and  in  the  same 
year  the  first  essay  was  published  in  which  inoculation 
was  recommended. 

Dr.  de  Castro^  stated  that  it  was  employed  by 
the  Greeks,  Turks,  and  Italians,  and  that  it  was 
probably  introduced  by  ignorant  peasants. 

"  That  it  first  proceeded  from  some  of  the  populace  who  were 
neither  men  of  Fortune,  Character,  nor  Learning,  seems  to  me  very 
probable,  in  that  it  appeared  in  the  World  without  the  least  i  ecom- 
mendation  from  any  of  the  Learned,  and  met  with  very  considerable 
opposition  from  the  rich." 

We    learn    from    this    essay  that    inoculation    was   at 

this  date  secretly  employed  in   London. 

"  I  have  had  it  very  well  attested  to  me,  that  a  Certain  Gentle- 
man of  this  City  had  the  operation  performed  upon  two  of  his 
Children  this  last  winter  ;  and  that  his  expectations  were  fully 
answered  in  the  event.  " 

De  Castro  advocated  arm  to  arm  variolation. 

'  A  Dissertation  on  the  Method  of  inoculating  the  Small  Pox.  By 
J.C,  M.D.,  1721. 


GREAT  BRITAIN  AND  IRELAND.  35 

"  There  are  few  or  none  that  make  use  of  the  Pus  extracted 
from  an}'  who  have  this  Disease  by  transplantation,  but  this  being 
of  a  milder  Disposition  (I  am  very  incHnable  to  believe),  will  be  as 
proper  as  any  other." 

His  pamphlet  concludes  by  a  recommendation  to 
physicians  to  introduce  the  practice,  as  it  was  always 
attended   with  success. 

"  There,  if  I  am  not  very  much  mistaken  (being  a  real  matter  of 
fact),  may  be  a  sufficient  encouragement  to  all,  especially  the  Fair 
Sex,  to  endeavour  to  have  this  method  introduced  and  practised 
in  this  Kingdom  ;  as  also  to  the  Physicians  to  direct  their  Friends 
and  Acquaintances  to  admit  of  the  operation." 

Very  shortly  after  the  issue  of  this  pamphlet,  Dr. 
Harris  delivered  a  lecture^  before  the  College  of 
Physicians  of  London,  and  described  the  Byzantine  and 
Chinese  methods.  He  was  the  first  to  mention  inocula- 
tion by  means  of  a  thread  imbued  with  the  variolous  pus, 
which  method  had  been  successfully  practised  upon  four 
children  of  the  French  Consul  at  Aleppo,  when  secretary 
to  the  Marquis  de  Chateauneuf  at  Constantinople. 

But  it  was  not,  as  already  stated,  until  April  1721 
that,  owing  to  the  enthusiasm  of  Lady  Mary  Wortley 
Montagu,  the  Byzantine  method  was  openly  employed 
in  Ena^land.  After  the  successful  result  of  the  inocu- 
lation  of  her  son  in  Turkey,  Lady  Mary  determined  to 
submit  her  daughter,  an  infant  three  months  old,  to 
the   same  operation.      This  was   postponed    for  a  while, 

'  De  Peste  Dissei'tatio,  1721   (quoted  by  Woodville). 


-,6  SMALL  POX  INOCULATION. 


but  was  eventually  carried  out  in  England  by  Maitland, 
in   April    1721. 

Maitland  performed  a  second  inoculation,  in  the 
following  May,  upon  the  son  of  Dr.  Keith,  with  a 
favourable  result.  This  was  soon  generally  known  in 
London,  for  the  news  spread  rapidly,  and  excited  the 
greatest  interest  among  people  of  all  ranks.  Never- 
theless, inoculation  made  very  little  progress,  for  it 
was  regarded  with  so  much  fear  and  suspicion,  that 
several  months  elapsed  before  a  third  trial  took  place 
in  London.  In  fact,  inoculation  was  regarded  as  of 
such  a  dangerous  nature,  that  an  attempt  was  not 
again  made  until  there  was  an  opportunity  of  inoculat- 
ing some  criminals  in  Newgate,  who  were  promised  a 
full  pardon  if  they  submitted  to  the  experiment.  They 
accepted  the  offer,  and  were  accordingly  inoculated 
by  Maitland  on  the  9th  of  August,  1721.  None  of 
them  had  the  disease  severely  ;  in  fact,  there  were  only 
sixty  pustules  on  the  one  in  whom  the  operation 
|)roduced  the  most  effect.  A  seventh  criminal  was 
experimented  upon  by  the  Chinese  method.  The 
disease  followed  in  a  mild  form,  but  the  patient  suffered 
from  severe  pains  in  her  head,  from  the  commencement 
of  the  eruption  to  the  maturation  of  the  pustules.  These 
cases,  however,  were  not  sufficient  to  convince  the  public 
of  the  safety  and  advantage  of  inoculation  ;  and  many 
contended  that  as  the  eruptions  were  so  few,  the  true 
disease   had   not   been   communicated,  and  therefore  the 


GREAT  BRITAIN  AND  IRELAND. 


inoculated  were  liable  to  the  disease  contracted  in  the 
ordinary  way.  Consequently  Maitland  inoculated  only 
eight  persons  in  the  following  six  months. 

In  the  account  given  by  Maitland^  of  these  cases, 
we  have  the  first  intimation  of  a  dans^er  arisinsf  from 
this  practice,  which  a  century  later  was  the  strongest 
argument  for  not  only  abandoning  it,  but  also  for  sup- 
pressive legislation.  The  first  of  these  patients  was 
Mary  Batt,  two  years  old,  the  daughter  of  a  Quaker, 
inoculated  October  2nd,  1721.  This  child,  having  only 
twenty  pustules,  soon  recovered. 

"  But  what  happened  afterwards  was,  I  must  own,  not  a  little 
surprising  to  me,  not  having  seen  or  observed  anything  like  it 
before.  The  case  was  in  short  this :  Six  of  Mr.  Batt's  domestic 
servants,  who  all  in  turn  were  wont  to  hug  and  caress  this  child 
whilst  under  the  operation,  and  whilst  the  pustules  were  out 
upon  her,  never  suspecting  them  to  be  catching  (nor  indeed  did  1), 
were  all  seized  at  once  with  the  right  natural  Small  Pox  of  several 
and  veiy  different  kinds." 

In  spite  of  this  disaster,  the  practice  was  adopted  by 
Dr.  Xettleton,  of  Halifax,  Yorkshire,  who  in  three 
months  inoculated  forty  persons.  Dr.  Nettleton  intro- 
duced a  system  of  preparing  his  patients  by  means  of 
purgatives,  emetics,  and  occasionally  by  bleeding.  Two 
incisions  were  made,  one  in  the  arm,  and  the  other  in 
the  leg  of  the  opposite  side,  and  variolous  matter 
dropped  into  the  wounds.  Later  he  employed  a  simpler 
method,  cotton-wool    being    impregnated   with    variolous 

'  Maitland.     Account  of  maculating  the  Small  Pox.     1722. 


38  SMALL   POX  LNOCULATLQN. 

pus,  and  applied  to  the  incisions  for  twenty-four  hours, 
by  means  of  a  plaster. 

In  1772,  inoculation  was  more  generally  adopted. 
The  Princess  of  Wales  ordered  it  to  be  practised 
upon  some  charity  children,  and  the  successful  result 
induced  Her  Royal  Highness  to  have  the  two  young 
princesses  inoculated.  They  were  both  successfully 
infected,  and  the  example  of  Her  Royal  Highness  was 
followed  by  others,  and  thus  much  encouragement  was 
given,  for  a  time,  to  the  new  practice. 

It  was,  however,  soon  destined  to  receive  a  great 
check,  for  the  Hon.  William  Spencer  and  the  butler 
of  Lord  Bathurst  had  both  of  them  a  copious  erup- 
tion, and  the  disease  in  both  cases  terminated  fatally. 
Another  patient.  Miss  Rigby,  died  about  eight  weeks 
after  inoculation,  so  that  there  were  3  deaths  in  182 
inoculations,  or  nearly    i    in   60. 

The  ill-success  that  had  attended  Maitland's  inocu- 
lations in  this  country,  caused  him  to  be  severely 
criticised,  and  it  was  generally  considered  that  he  had 
been  imposed  upon  by  the  old  women  in  Turkey.  For 
he  had  described  the  treatment  employed  in  Turkey,  as 
very  mild,  and  yet  he  had  had  deaths  in  consequence; 
and  further,  he  had  committed  himself  to  the  opinion 
that   the  inoculated   Small  Pox  was  not  infectious. 

Woodville,^  writing  more  than  seventy  years  after- 
wards, refers  to  these  failures  in  the  following  terms  : — 


'  Woodville,  loc.  cit.,  p    123. 


GREAT  BRITAIN  AND  IRELAND. 


39 


"  That  inoculation  did  not  constantly  succeed  in  producing  the 
distinct  or  favourable  kind  of  Small  Pox  was  at  that  time,  and  still 
continues  to  be,  a  melancholy  truth  ;  but  the  inoculators  were  at 
first  unwilling  to  acknowledge  it,  and  by  attemptmg  to  attribute 
the  death  of  persons  inoculated  to  other  accidental  causes,  exposed 
themselves  to  just  censure." 

A  strong  feeling  of  opposition  to  the  practice  arose, 
and  both  clergymen  and  physicians  became  ardent  anti- 
inoculators.  In  1722,  an  anonymous  pamphlet^  appeared, 
which  described  inoculation  as  the  outcome  of  atheism, 
quackery,  and  avarice.  The  Rev.  Mr.  Massey  preached 
a  sermon,  in  which  he  condemned  it  as  a  dangerous 
and  sinful  practice  ;  and  Dr.  Wagstaffe,^  a  physician  of 
St.  Bartholomew's  Hospital,  expressed  a  desire  to 
have  further  evidence  of  the  efficacy  of  inoculation,  and 
considered  that  posterity  would  marvel  that  a  practice 
employed  by  a  few  ignorant  women  amongst  an 
illiterate  and  unthinking  people,  should  have  so 
suddenly  been  adopted  by  one  of  the  politest  nations 
in  the  world.  In  criticising  the  cases  in  the  family  of 
Mr.   Batt,  he  said  : — 

"I  am  well  informed  by  Persons  of  unquestionable  reputation,  that 
the  Town  of  Hertford  is  a  lamentable  Evidence  of  the  danger  of 
this  practice,  where  the  Distemper  was  spread  by  it  to  that  degree, 
as  not  only  to  make  an  havock  of  the  Inhabitants,  but  to  hinder 
the  Commerce  of  the  place.  Thus  the  Operator  has  it  in  his  power 
to  convey  the  Small  Pox  to  distant  Places  and  Persons,  who  neither 

'  The  New  Practice  of  Inoculation  considei'ed,  a7id  an  Humble 
A-p;plication  to  the  Approaching  Parliainent  for  the  Regulation  of 
that  Dangerous  Experiment. 

'  Wagstaffe.     A  letter  to  Dr.  Freind.     1722. 


40  SMALL   POX  LNOCULATION. 

avow  his  practice  or  desire  his  experiment  :  And  if  'tis  possible 
that  the  ingrafted  Pox  can  be  so  poysonous  as  to  communicate 
certain  death  to  all  around  by  this  method,  they  may  ingraft  as 
violent  a  Plague  as  has  been  known  among  us.  How  far  the  Legis- 
lature may  think  fit  to  interpose,  in  order  to  prevent  such  an 
artificial  way  of  depopnlating  a  Country^  is  not  my  Province  to 
determine." 

The  anti-inoculators  were  in  turn  ansv^ered  by  Drs. 
Crawford,^  Brady,-  Williams,^  and  Maitland/  The  sub- 
ject gave  rise  to  such  an  acute  controversy,  that  these 
publications  were  in  turn  repHed  to  in  the  same  year. 

Mr.  Tanner,^  a  surgeon  at  St.  Thomas's  Hospital, 
declared  that  he  had  inoculated  a  person  who  had  had 
Small  Pox  several  years  previously,  and  that  a  dis- 
charge from  the  incisions,  and  irregular  eruptions, 
followed,  "  appearances  which  the  inoculators  in  the 
experiments  at  Newgate  had  deemed  sufficient  to 
prevent  the  patient's  having  the  Small  Pox  in  future." 

The  opposition  was  counteracted  by  the  letters  of 
Dr.  Jurin,"  who  examined  the  question  by  means  of 
statistics.  He  arrived  at  the  conclusion  that  of  all 
children     born,     i    in    14    dies   some    time    or    other   of 

'  Crawford.  The  Caseof  Lnoctilatiiig  the  Small  Fox  considered,  and 
its  Advantages  asserted. 

^  Brady.  Some  Remarks  on  Dr.  Wagstaffe' s  Letter  and  Air.  Massefs 
Sermon. 

•■'  Williams.  Some  Remarks  on  Dr.  Wagstaffe's  Letter,  with  an 
Appetidix. 

■*  Maitland.  Mr.  Maitland' s  Account  of  inoculating  the  Small  Pox 
vindicated. 

■''  Blackmore.     Treatise  on  the  Small  Pox,  p.  92. 

*  Jurin.    Letter  to  Dr.  Cotesworth. 


GREAT  BRITAIN  AND  IRELAND.  41 

Small  Pox,  while  of  all  persons  inoculated  with  choice 
of  subjects,  only  i  dies  in  91.  Jurin  decided  in  favour 
of  inoculation,  and  in  consequence  it  continued  to 
make    steady    progress. 

In  1723,  it  was  advocated  by  persons  of  rank,  and 
by  the  heads  of  the  Church.  The  number  of  persons 
inoculated  during  the  years  1 721-3  amounted  to  474, 
9  of  whom  died.  There  are  several  points  of  interest 
in  the  history  of  these  cases.  In  the  first  place, 
in  addition  to  the  fact  that  9  died  as  the  result  of 
inoculation,  there  were  29  in  whom  inoculation  had 
no  effect,  and  in  5  it  had  an  imperfect  effect.  Of 
the  29  in  which  there  was  no  effect.  9  occurred 
between   the   ages   of  twenty  and  fifty-two. 

In  1724,  there  were  only  40  persons  inoculated; 
but  Dr.  Jurin  considered  that  it  was  not  unnatural 
that  people  should  object  to  a  practice  in  which 
there  was  risk,  unless  impelled  to  it  by  the  dread 
of  a  greater  danger  ;  and  in  this  year,  natural  Small 
Pox  had  somewhat  abated.  In  1725,  natural  Small 
Pox  was  very  fatal,  and  people  again  resorted  to 
inoculation.  But  in  1727-8,  the  practice  began 
to  decline,  in  spite  of  the  fact  that  Small  Pox 
generally  prevailed.  In  these  two  years,  only  124 
were  inoculated,  87  and  ■}^']  respectively,  and  3 
died  from  the  effects  of  the  operation.  The  first 
was  a  son  of  Mr.  Wansey,  of  Warminster,  aged 
one  year  and  a  half  ;   the  second  was   Enoch  Trumble, 


42  SMALL  POX  INOCULATLON. 

aged  eight  months  ;  and  the  third  was  a  boy  eleven 
years  old,  the  son  of  a  person  of  rank  in  London, 
whose  name  was  concealed.  Thus,  during  the  first 
eight  years  of  inoculation  in  Great  Britain,  there  were 
897  persons  inoculated  ;  845  had  true  variolous  pustules, 
13  an  imperfect  eruption,  in  39  no  distemper  was  pro- 
duced by  the  operation,  and  17  died.  With  regard  to 
the  13  having  an  imperfect  eruption.  Dr.  Scheuchzer  ^ 
says  : — 

"By  having  an  imperfect  Small  Pox  is  meant  the  having 
some  slighter  eruption  of  but  a  few  days'  continuance,  but  this 
attended  with  an  inflammation  and  running  of  the  incisions 
for  the  usual  time,  and  generally  preceded  by  some  of  the 
common  symptoms  of  the  Small  Pox ;  this  being  esteemed  by 
the  accounts  from  Turkey,  and  our  own  experience  at  home 
as  far  as  it  goes,  to  be  an  effectual  security  against  having  the 
Small   Pox   afterwards   in  the   natural  way." 

In  spite  of  the  fatal  cases,  an  advantage  was  claimed 
for  inoculation,  in  that  it  had  been  calculated,  that  or 
all  those  affected  with  Small  Pox  in  the  ordinary  way, 
about  one  in  six  died,  whereas  the  deaths  from  inocu- 
lation contended  for  by  the  anti-inoculators  amounted 
to  not  more  than  one  in  fifty.  In  1731,  a  pamphlet 
was  published  exposing  the  fallacies  in  Dr.  Jurin's 
and  Dr.  Scheuchzer's  statistics,  and  claiming  that  the 
advantage  of  the  inoculated  Small  Pox  over  the 
natural   disease   was   fictitious.       The  writer  maintained 

'  .Schcuchzer,  /or.  cit. 

'^  Au  Enquiry  into  the  Advantages  received  by  the  First  Eight  Years' 
Inocula  tion .     1 73 1 . 


GREAT  BRITAIN  AND  IRELAND. 


43 


that  by  inoculation  the  variolous  infection  was  spread 
far  and  wide,  and  a  considerable  increase  of  mortality 
by  Small  Pox  occasioned  ;  thus  the  lives  saved  to 
the  persons  themselves  inoculated  fell  short  of  the 
lives  lost  from  the  increased  infection.  To  this 
pamphlet  no  direct  reply  was  forthcoming,  but  papers 
both  in  tavour  of  and  against  inoculation,  continued 
to  be  issued  from  time  to  time.  Dr.  Warren  regarded 
it  as  a  "  barbarous  and  dangerous  invention  imported 
from   Turkey." 

The  successful  and  encouraging  results  reported 
trom  America,  and  the  increase  in  the  fatality  of  the 
natural  Small  Pox  in  Great  Britain,  led  to  a  revival 
of  the  practice  of  inoculation,  so  that  after  1738,  it 
was  very  generally  employed.  In  5  towns,  2,000 
were  inoculated  in  1742,  of  whom  2  women,  both  with 
child,  died.  In  1753,  422  inoculations  were  made, 
with  4  deaths.  At  Rye,  in  Sussex,  300  people  were 
inoculated,  with  i  death,  and  at  Blandford,  in  Dorset- 
shire, 400,  with  only  i  death.  In  London,  out  of 
1,500  cases,  only  3  terminated  unfavourably.  At  the 
Foundling  Hospital,  186  were  inoculated,  and  i  died  ; 
and  the  same  surgeon  who  had  inoculated  these  cases 
lost,  in  private  practice,  only  i  case  in  370.  The 
progress  made  by  inoculation  at  this  period  was  in  a 
great  measure  due  to  Dr.  Mead's^  publication  in  1747, 
in    which    he    devoted    a    chapter    to    inoculation,   and 

'Mead.     Small  Pax  and  Measles.     1747. 


44 


SMALL   POX  INOCULATION. 


Spoke  in  favour  of  it,  and  to  Dr.  Frewen's^  work, 
which  claimed  a  great  success  for  this  treatment.  In 
the  year  1746,  the  art  of  inoculation  was  still  further 
encouraged  by  the  establishment  of  an  Inoculation 
Hospital.  But  the  public  were  still  very  strongly 
prejudiced  against  it,  and  the  patients  on  leaving  the 
hospital  were  often  abused  and  insulted  in  the  street, 
so  that  they  were  not  suffered  to  depart  until  the 
darkness  of  the  night  enabled  them  to  do  so  without 
being  observed.'^  These  prejudices  were  gradually 
overcome  in  various  ways.  Dr.  Maddox,  Bishop  of 
Worcester,  President  of  the  Small  Pox  Hospital, 
preached  a  powerful  sermon,  which  was  published, 
and  passed  through  seven  editions.  This  had  a  great 
effect  upon  the  public  mind,  as  well  as  the  fact  that 
out  of  593  persons  successfully  treated,  only  i  died. 
Inoculation  now  made  uninterrupted  progress.  At 
the  same  time,  the  opposition  of  the  anti-inoculators 
was  not  silenced.  An  anonymous  discourse  was 
published  in  1751,  and  the  Rev.  Theodore  De  la 
Faye^  preached  a  sermon  as  powerful  as  that  of  the 
Bishop  of  Worcester,  and  in  opposition  to  his  conclu- 
sions. The  sermon  was  replied  to  by  Mr.  Bolalne* 
and    Dr.    Kirkpatrick.^      These  were   answered    by   De 

'  Frewen.    The  Practice  and  Theory  of  Inoculation,  with  an  Account 
nf  its  Success. 

■  Woodville,  luc.  cit.,  p.  238. 

■'*  De  la  Faye.     Inoculation  an  hidefensible  Practice.     1753. 

^  Bolaine.     Letter  addressed  to  Mr.  de  la  Faye. 

'■  Kirkpatrick.     llie  Analysis  of  Inoculation. 


GREAT  BRITAIN  AND  IRELAND.  45 

la  Faye,^  which  in  turn  called  forth  another  pamphlet 
from  Mr.  Bolaine.'  Mr.  David  Some  and  Dr.  Dodd- 
ridge, "  two  respectable  divines,"  were  also  in  favour 
of  the  new  practice."'  Early  in  the  year  1754,  two 
works  recommending  inoculation  were  published,  one 
by   Mr.   Burgess,  and  the  other  by   Dr.    Kirkpatrick. 

In  the  same  year,  it  was  resolved  to  inoculate  the 
three  royal  children  who  had  not  yet  had  Small 
Pox.  In  the  meantime,  the  Prince  of  Wales  took  the 
disease  casually,  and  Prince  Edward  and  Princess 
Augusta  were  inoculated  with  variolous  matter  taken 
from  him.  This  fact,  and  particularly  the  following 
declaration  of  the  College  of  Physicians,  still  further 
tended   to  establish   the   practice. 

"  The  College,  having  been  informed  that  false  reports 
conxerning  the  success  of  inoculation  in  england  have 
been  published  in  foreign  countries,  think  proper  to  declare 

THEIR     SENTIMENTS    IN     THE    FOLLOWING     MANNER,    VIZ.  : ThAT     THE 

ARGUMENTS  WHICH  AT  THE  COMMENCEMENT  OF  THIS  PRACTICE 
WERE  URGED  AGAINST  IT  HAVE  BEEN  REFUTED  BY  EXPERIENCE  ; 
THAT  IT  IS  NOW  HELD  BY  THE  ENGLISH  IN  GREATER  ESTEEM,  AND 
PRACTISED  AMONG  THEM  MORE  EXTENSIVELY  THAN  EVER  IT  W-AS 
BEFORE  ;  AND  THAT  THE  CoLLEGE  THINKS  IT  TO  BE  HIGHLY 
SALUTARY    TO    THE    HUMAN    RACE." 

In  1758,  an  anonymous  address  was  published,  in 
which    the    writer    wished     to    restrict    the    practice    of 

'  De  la  Faye.     A   Vindicatio7i  of  a  Sertnon,  etc. 

*  Bolaine.  Retnarks  on  the  Rev.  Mr.  de  la  Faye's  Vindication  of  his 
Sermon. 

'  Some  and  Doddridge.  'The  Case  of  receiving  the  Small  Pox  by 
Inoculatioti  impartially  considered. 


46  SMALL   POX  LNOCULATLON. 

inoculation  to  the  physicians.  This  was  speedily- 
answered  by  Mr.  Cooper,  a  surgeon.  In  1759,  Dr. 
Franklin  gave  an  account  of  the  success  of  inoculation 
in  England  and  America,  and  wrote  to  the  effect 
"  that  it  did  not  seem  to  make  that  progress  among 
the  common  people  of  America  which  at  first  was 
expected."  Dr.  Heberden  followed  with  Plain 
InsU'ucHons  for  Inoc2Llation,  and  in  1761,  a  second 
edition  of  Dr.  Kirkpatrick's  work  appeared.  He 
was  the  first  writer  to  give  an  account  of  inocula- 
tion by  vesication  or  blister,  a  method  which  appears 
to  have  been  made  use  of  in  Paris  by  Dr.  Tronchin 
as  early  as  1756.  In  1764,  Dr.  Alexander  Munro 
gave  an  account  of  the  inoculation  of  Small  Pox  in 
Scotland,  and  in  1765,  the  practice  of  inoculation  was 
"  impartially  considered "  by  Dr.  Andrews,  of  Exeter, 
and   its   "  signal  advantages  fully   approved." 

A  new  epoch  in  the  history  of  inoculation  commenced 
with  the  introduction  of  the  Suttonian  method,  which 
■'in  the  year  1765,  had  extended  so  rapidly  in  the 
counties  of  Essex  and  Kent,  as  to  much  interest  the 
public,  who  were  not  less  surprised  by  the  novel  method 
in  which  it  was  conducted,  than  by  the  uninterrupted 
success  with  which  it  was  attended,  upon  a  prodigious 
number  of  persons." 

Mr.  Robert  Sutton,  who  acquired  great  celebrity 
as  an  inoculator,  lived  at  Debenham  in  Suffolk,  where  he 
practised  surgery  and   pharmacy.       He  began  the  prac- 


GREAl  BRITAIN  AND  IRELAND.  47 

tice  of  inoculation  in  1757,  and  in  eleven  years  inoculated 
2.514  persons.  His  sons,  Robert  and  Daniel,  following 
the  medical  profession,  assisted  him  during  the  first  three 
vears  of  his  practice.  Robert  established  himself  as 
an  inoculator  at  Bury  St.  Edmunds,  while  Daniel, 
after  being  an  assistant  to  a  surgeon  at  Oxford,  returned 
to  Debenham,  and  suggested  to  his  father  a  new  plan 
of  inoculation.  It  was  said  that  he  proposed  to  shorten 
the  time  of  preparation  to  a  few  days,  and  not  to  con- 
fine the  inoculated  patients  to  the  house,  but  to 
oblige  them  to  be  exposed  as  much  as  possible  to 
the  open  air.  The  father  condemned  the  scheme  ; 
but  the  treatment  was  so  approved  of  by  the  patients, 
that  they  desired  to  be  inoculated  by  the  son,  rather 
than  by  the  father,  which  led  to  a  quarrel  and  a 
separation.  Mr.  D.  Sutton  then  opened  an  Inocula- 
tion House  near  Ingatestone,  in  Essex.  Here  he 
made  known,  by  advertisements  and  handbills,  his 
intention  of  inoculating  on  an  improved  principle,  and 
hinted  that  by  the  use  of  certain  medicines,  he  could 
keep  the  disease  entirely  under  his  control.  His 
system  was  so  appreciated,  that  at  the  end  of  the  first 
year,  his  practice  produced  him  two  thousand  guineas, 
and  in  the  second  year,  his  fees  amounted  to  more 
'  than  three  times  that  sum.  He  obtained  such  a 
widespread  reputation,  and  his  patients  were  so 
numerous,  that  it  was  difficult  to  accommodate  them 
in    the     village     of     Ingatestone.       Mr.      Sutton     also 


48  SMALL   POX  INOCULATLON. 

employed  a  clergyman,  who  preached  sermons,  and 
wrote  exaggerated  accounts  of  his  results.  The 
Rev.  Robert  Houlton,  the  advocating  clergyman,  attri- 
buted the  success  to  Mr.  Sutton's  treatment.  He  said 
"  that  not  one  person  out  of  a  thousand  inoculated 
by  Mr.  Sutton  had  more  variolous  pustules  than  he 
could  wish,  and  that  if  any  patient  had  twenty  or  thirty 
pustules  he  was  said  to  have  the  Small  Pox  very 
heavily^  The  reason  that  Mr.  Houlton  gave  for 
this  was,  that  Mr.  Sutton,  perceiving  a  symptom 
in  the  patients  of  great  fever,  or  a  probability  of  their 
having  more  pustules  than  they  would  choose,  quickly 
prevented  both  by  virtue  of  his  medicines,  for  "  the 
Sutton  family  is  in  possession  of  an  inestimable 
medicine,  by  use  of  which  too  great  a  burden  of  pus- 
ules  can  infallibly  be  prevented."  According  to 
Mr.  Houlton,  the  number  of  persons  inoculated  by 
Mr,  Daniel  Sutton,  from  1764-6,  amounted  to  13,792  ; 
and,  with  the  aid  of  his  assistants,  he  had  inoculated 
altogether  20,000  persons.  He  denied  that  a  single 
patient  had  died  fairly  from  the  inoculation,  the  deaths 
which  had  occurred  being  attributed  to  other  causes. 
Woodville,^  in  referring  to  this  new  method,  says  :  — 

"  Though  this  and  other  accounts  of  Mr.  Sutton's  practice 
magnified  it  beyond  its  real  merit,  yet  not  a  doubt  was  enter- 
tained but  that  the  Suttonian  plan  of  inoculation  was  incomparably 
more  successful  than  that  of  any  other  practitioner."  .  .   . 

'  Woodville,  loc.  cit.,  p.  353. 


GREAT  B RITA IX  AND  IREIAXD. 


49 


It  is  not  surprising  that  physicians  were  extremely 
anxious  to  find  out  the  secret  of  Mr.  vSutton's  success. 
Dr.  Baker^  was  one  of  the  first  to  get  detailed  in- 
formation of  the  new  method,  and  he  published  an 
account  ot  it.  Dr.  Rushlin,  by  means  of  an  "  ingeni- 
ous gentleman  who  was  conversant  with  Mr.  Sutton's 
patients,"  obtained  samples  of  the  medicines,  and 
subjected  them  to  analysis.  Dr.  Langton  described 
the  method  as  a  gross  imposition,  and  argued  that 
the  matter   communicated  was   not   the   Small    Pox. 

He  pointed  out  that  the  practice  was,  to  take  the 
virus  the  fourth  day  after  the  incision    was   made. 

"  By  this  means  you  have  a  contagious  caustic  ivatcr  instead 
of  laudable  pus,  and  a  slight  ferment  in  the  lymph  is  raised, 
producing  a  few  watery  blotches  in  the  place  of  a  perfect  extru- 
sion of  the  variolous  matter." 

In  1767,  the  arguments  of  Dr.  Langton  and  ]\Ir. 
Bromfield  were  replied  to  by  Dr.  Giles  Watts."  To 
explain  why  the  effect  of  the  new  treatment  was  so 
slight,  and  to  justify  it,  it  was  said  that  the  aim  was 
to  get  inoculation  without  pustules,  because  they  were 
mindful  of  the  observation  of  Dr.  Boerhaave,  that  the 
Small  Pox  often  happened  without  any  pustules  at  all. 
That  the  result  of  the  Suttonian  inoculation  was,  as  a_ 
rule,  very  slight  indeed,  was  admitted. 

'  Baker.  A/i  Inquiry  into  the  Merits  of  a  Method  of  Inoctdatiitg  the 
Small  Pox.     1766. 

*  Giles  Watts.  A  Vindication  of  the  New  Method  of  Inoculating  the 
Small  Pox.     1767. 

VOL.  I.  4 


50  SMALL  POX  LNOCULATLON. 


"  To  say  the  truth,  it  is  a  fact  well  known  to  inoculators  in 
this  wa}',  and  I  have  sometimes  known  the  same  happen  in  the 
old,  that  the  patients  pretty  often  pass  through  the  Small  Pox 
so  easily,  as  to  have  no  more  than  five  pustules.  Nay,  it  happens 
every  now  and  then  in  this  way  of  inoculation,  that  even  an  adult 
patient  shall  pass  through  the  distemper  without  having  one,  or 
even  so  much  as  a  single  complaint  other  than  perhaps  a  slight 
shivering  chill  or  some  such  trifling  disorder,  which  he  would 
hardly  have  taken  the  least  notice  of  at  any  other  time,  so  very 
powerful  is  the  present  method  of  preparation  and  management 
in  lessening  the  violence  of  the  distemper.  When  this  happens, 
and  especially  if  it  happens  without  a  considerable  inflammation 
of  the  skin  round  the  puncture,  the  patient  can  hardly  be  brought 
to  believe  he  has  had  the  Small  Pox.  In  such  cases,  it  is  ever 
prudent  in  the  operator  for  the  satisfaction  of  the  patients  to 
inoculate  them  again." 

Dr.  Giles  Watts  also  considered  that  Dr.  Lano^ton's 
criticism    was  wide   of  the  mark. 

"  It  was,  without  doubt,  the  practice  of  Mr.  Sutton  to  inoculate 
from  the  punctures  on  the  arms  of  his  patients  while  the  matter 
in  thcju  zvas  yet  crude,  and  before  the  eruptive  symptoms  came  on. 
And  it  seems  as  if  he  looked  on  this  as  a  necessary  caution,  in 
order  to  render  the  distemper,  so  inoculated,  light  on  the  patient." 

But  while  admitting  this,  Dr.  Giles  Watts  was  of 
opinion  that  it  did  not  matter  whether  the  patient 
were  inoculated  with  crude  variolous  lymph  or  yellow 
concocted   variolous  matter. 

In  spite  of  criticism,  the  Suttonian  method  of  inocu- 
lation gained  general  approval;  and  even  in  1815, 
Moore^  spoke  disapprovingly  only  of  Sutton's  unpro- 
fessional  conduct. 


'  Moore,  The  History  of  the  Small  Pox,  p.  270.     1815. 


I 


GREAT  BRITAIN  AND  IRELAND.  51 


"  It  is  much  to  be  regretted  that  Daniel  Sutton  should  have 
stooped  to  employ  such  unworthy  devices,  for  his  plan  of  treat- 
ment was  greatly  superior  to  that  of  any  former  practitioner, 
and  had  he  followed  the  correct  rules  of  open  professional  conduct, 
his  name  would  have  been  recorded  with  honourable  distinction." 

It  was  impossible  to  entirely  conceal  the  method. 
Physicians  and  chemists  not  only  analysed  his  medi- 
cines, but  endeavoured  to  find  out  the  whole  system. 
Information  was  obtained  from  his  patients,  and  as 
he  communicated  his  treatment  to  many  distant 
practitioners  on  condition  of  half  profits,  the  secret 
could  not  long  be  kept.  The  essential  points  were 
all  discovered.  Dr.  Dimsdale^  was  one  of  the  first 
to  turn  the  Suttonian  system  to  good  account.  He 
adopted  the  method  in  his  own  practice,  and  incor- 
porated an  account  of  all  the  essential  part  of  the  new 
method  in  a  treatise  on  inoculation. 

Dimsdale  became  so  famous  for  his  inoculations, 
that  when  the  Empress  of  Russia  desired  to  be  sub- 
mitted to  the  operation,  he  was  appointed  to  perform 
it.  His  tracts  on  inoculation,  which  were  written  and 
published  at  St.  Petersburg,  will  be  referred  to  in  detail 
in  discussing  the  Suttonian  method  and  its  results. 

In  consequence  of  Dimsdale's  works,  inoculation  be- 
came for  a  time  very  much  more  popular  than  before. 
It  was  rivalled  by  Cow  Pox  inoculation  in  1798,  and 
finally  forbidden  by  Act  of  Parliament   in    1840. 


'  Dimsdale.     The  Present  Method  of  Inoculating  fo7-  the  Small  Pox. 
1779- 


CHAPTER  III. 

THE    OPERATION   OF  INOCULATION. 

The  accounts  of  inoculation  which  have  already- 
been  given,  have  included  several  different  methods  of 
performing  the  operation.  But  the  writers  who  first 
described  the  custom  which  prevailed  in  different  parts  of 
the  world,  of  "buying"  or  "ingrafting"  the  Small  Pox, 
were  unacquainted  with  the  details  which  were  essential 
for  the  performance  of  the  operation  with  comparative 
safety  ;  and  it  is  only  by  regarding  their  descriptions  in 
the  light  of  events  which  followed  the  introduction  of 
the  practice  into  this  country,  that  we  can  fully  appre- 
ciate the  fact  that  inoculators  in  the  East  were  tauQ-ht 
many  necessary  precautions  by  long  experience. 

Practice  of  the  Brahmins. — In  Hindostan,  the 
operation  was  performed  only  at  certain  seasons  of  the 
year,  and  a  preparatory  regimen  was  enforced.  Probably, 
the  Brahmins  selected  the  subjects  for  inoculation,  as 
well  as  the  subjects  from  whom  they  took  the  variolous 
matter.  They  had  certainly  learnt  by  experience  the 
varying  intensity  of  the  contents  of  the  Small  Pox 
pustule,  for  they  were  credited  with  being  able  to  control 
the  amount  of  eruption  by  the   method  of  operation. 


OPERATION  AND   TREATMENT.  53 


Practice  of  the  Greeks. — The  old  Grecian  women 
were  still  more  cautious  in  their  procedure,  and, 
according  to  Gatti/  inoculated  tens  of  thousands 
without  an  accident.  They  dispensed  with  a  pre- 
paratory treatment,  as  they  only  operated  upon  those 
in  perfect  health. 

**  All  that  is  considered  is  whether  the  breath  is  sweet,  the 
skin  soft,  and  whether  a  little  wound  in  it  heals  easily. 
Whenever  these  conditions  are  found,  they  inoculate  without 
the  least  apprehension  of  danger." 

Having  selected   their  subjects,    they  made  punctures 

with     needles,    and     were    particularly    careful    "  in    the 

choice    of  the  Ferment;''    variolous    matter   being    used 

in  the   crude    state,   freshly   obtained   from    "  the    kindly 

pnstules  of  a  young  child ^ 

Maitland's,  or  the  English  Practice.— When 
Lady  Mary  Wortley  Montagu  had  her  child  inoculated 
at  Pera,  an  old  Greek  woman  was  employed  to  insert 
the  variolous  matter.  But  Mr.  Maitland,  who  was 
present,  disapproved  of  the  method,  of  which  he  gave 
the  following  account : — 

"  But  the  good  woman  went  to  work  so  awkwardly,  and 
b}'  the  shaking  of  her  hand  put  the  child  to  so  much  torture 
with  her  blunt  and  rusty  needle,  that  I  pitied  his  cries,  and 
therefore  inoculated  the  other  arm  with  my  own  instrument, 
and  with  so  little  pain  to  him  that  he  did  not  in  the  least 
complain   of  it." 

When  the  same  surgeon    operated   on   the    Newgate 

'  Quoted  by  Baker,  /oc.  cit.,  p.  26. 


54  SMALL   POX  LNOCULATLON. 


criminals,  incisions  were  made  through  the  cutis,  and 
pledgets  applied  which  had  been  steeped  in  variolous 
pus  from  ripe  pustules.  This  method,  called  the 
Improved  or  Reformed  operation,  was  soon  modified, 
for  frequently  very  troublesome  ulcers  resulted.  Kirk- 
patrick  mentions  the  case  of  a  young  gentleman  who, 
with  a  favourable  eruption  by  inoculation,  had  never- 
theless an  arm  so  terribly  ulcerated  that  amputation 
was  apprehended. 

Maitland  performed  the  operation  without  selection 
of  subjects  or  other  precautions,  and  consequently 
with  occasionally  disastrous  results  similar  to  the 
examples  which  have  already  been  given. ^ 

Jurin's  Practice. — In  1729,  Dr.  Jurin  recom- 
mended— 

"  Firstly.  Great  care  to  be  taken  only  to  inoculate  none  but 
persons  of  a  good  habit  of  body,  and  free  not  only  from  any 
apparent,  but,  as  far  as  could  be  judged,  from  any  latent  disease. 

"  Secondly.  The  body,  especially  if  plethoric,  ought  to  be 
prepared  by  proper  evacuations,  bleeding,  purging,  vomiting,  etc. 

"  Thirdly.  The  utmost  caution  ought  to  be  used  in  the 
choice  of  proper  matter  to  communicate  the  infection.  It  should 
be  taken  from  a  young  subject,  otherwise  perfectly  sound  and 
healthful,  who  has  the  Small  Pox  in  the  most  favourable  manner. 
When  the  pustules  were  perfectly  maturated,  and  just  upon  the 
turn  or  soon  after,  two  or  three  of  them  should  be  ripped  with 
a  glover's  needle  or  small  lancet,  and  a  couple  of  small  pledgets 
of  lint  or  cotton  are  to  be  well  moistened  with  the  matter, 
and  immediately  put  into  a  little  vial  or  box,  and  carried  in 
the  warm  hand  or  bosom  of  the  operator  to  the  house  of  the 
person  to  be  inoculated. 

'   Vide  pp.  20,  28,  2i1- 


OPERATION  AND   TREATMENT.  55 

^^  Fourthly.  The  incisions  are  usually  made  with  a  small 
lancet  in  the  brawny  part  of  both  arms,  or  in  one  arm  and  the 
opposite  leg,  cutting  just  into  or  at  most  through  the  cutis  or 
true  skin  for  the  length  of  a  quarter  of  an  inch,  half  an  inch, 
or  at  most  an  inch.  This  being  done,  one  of  the  pledgets 
moistened  with  the  infectious  matter  is  to  be  laid  upon  each 
incision,  and  to  be  kept  on,  by  means  of  a  bit  of  sticking  plaister 
laid  over  it,  for  about  four  and  twenty  hours  ;  after  which,  all 
may  be  taken  off,  and  the  incision  dressed  with  common 
diachylon,  or  with  only  warm  cabbage  and  colewort  leaves 
once  a  day  at  first ;  and  afterwards,  when  the  discharge  is 
considerable,  twice  a  day  till  they  heal ;  or  only  with  a  linen 
roller   to  defend   them   from  the   air. 

"  Fifthly.  The  person  inoculated  sometimes  receives  the 
Small  Pox  without  any  previous  sickness,  as  often  happens 
in  the  most  favourable  sort  in  the  natural  way.  But  the  greater 
part  begin  to  be  a  little  feverish,  and  have  more  or  less  of 
the  usual  symptoms  preceding  the  natural  Small  Pox,  most 
commonly  upon  the  eighth  day  from  inoculation,  though  pretty 
often  upon  the  seventh,  and  very  rarely  a  day  or  two  sooner 
or  later. 

"  Sixthly.  The  patients  are  sometimes  taken  with  flushing 
heats,  which  disappear  again  in  a  little  time,  about  the  fourth 
cr  fifth  day ;  but  the  eruption  of  the  pustules  happened  generally 
within  a  day,  or  sometimes  two  or  three  after  the  sickening, 
viz.,  most  commonl}'  on  the  ninth  day,  less  frequently  on  the 
tenth,  and  still  less  on  the  eighth  or  eleventh.  In  a  few  cases 
it  appeared  on  the  seventh  or  twelfth,  in  one  case  on  the 
eighteenth,  in  one  on  the  twenty  fourth,  and  in  one  on  the 
sixth,  and  in  one  on  the  third.  The  last  patient  but  one 
had  the  confluent  sort,  and  died.  The  last  was  very  full  of 
the  distinct  kind,  and  recovered. 

"  Seventhly.  The  incisions  begin  to  grow  sore  and  painful 
about  the  fourth  or  fifth  day,  and  about  the  sixth,  seventh, 
or  eighth,  they  begin  to  digest  and  run  with  a  thick  purulent 
matter,  which  gradually  increases  till  about  the  turn  of  the 
distemper,  during  which  time  the  wounds  grow  wide  and  deep  ; 
afterwards,     the    running    gradually    abates,    and    they    usually 


56  SMALL   POX  LNOCULATLON. 


heal  up  in  about  a  month,  sometimes  in  three  weeks ;  though, 
in  some,  the}^  continue  running  five  or  six  weeks,  or  some- 
times longer.  The  greater  the  discharge  is  by  the  incisions, 
the  more  favourable  the  distemper  is  found  in  other  respects. 
When  the  inoculation  does  not  take  eifect,  the  incisions  heal  up 
in  a  few  days,  like  a  common  cut." 

Dr.  Jurin  says  nothing  about  medicinal  treatment ; 
but,  according  to  Dr.  Whitaker,  the  patients  were 
restricted  to  a  vegetable  diet,  and  were  never  exposed 
to  the  cold  air,  but  were  kept  in  a  warm  room, 
especially  during  the  eruptive  fever.  When  the  fever 
was  considerable,  bleeding,  blistering,  and  diaphoretics 
were  employed,  with  occasional  recourse  to  anodynes. 
After  the  appearance  of  the  eruption,  the  same  treat- 
ment as  was  followed  in  the  natural   Small   Pox. 

Practice  of  Burgess. — In  spite  of  the  precautions 
which  had  been  recommended  by  Jurin,  inoculation  still 
continued  to  be  followed  occasionally  by  bad  results. 
It  was  by  no  means  a  safe  operation,  and  in  order  to 
diminish  the  risks,  Mr.  James  Burgess  published,  in 
1766,  an  account  of  the  necessary  preparations  and 
management,   with   additions  and  improvements. 

Method  of  Preparation. — The  patient  was  enjoined 
to  avoid  all  excesses,  and  to  be  reo^ular  and  moderate 
in  taking  exercise  ;  the  latter  was  considered  necessary 
in  order  to  promote  the  natural  secretions  and  diminish 
the  disposition  of  the  blood  to  inflammation.  Diet 
was  to  be  restricted  both  in  quantity  and  quality.  A 
gentle    purgative    was    administered   at    the  end    of  the 


OPERATION  AND   TREATMENT. 


second  week  of  preparation,  and  this  was  repeated 
three  times,  at  intervals  of  three  days.  For  children 
a  dose  of  manna  or  syrup  of  roses  was  sufficient. 
Adults  were  to  be  entirely  free  from  business  of  all 
kinds  during  this  period,  to  avoid  all  close  application 
and  sitting  long  at  reading,  being  recommended  to  pass 
the  time  agreeably  with  a  few  friends.  Exercise  was 
to  be  taken  only  during  the  day  and  when  the  w^eather 
was  fine  ;  all  fatigue  of  body  and  anxiety  of  mind 
carefully  avoided.  In  fact,  the  course  of  preparation 
could  be  summed  up  in  three  words — "  temperance, 
quiet,  and  cheerfulness."  The  patient,  being  in  a 
proper  state  of  body  and  mind,  would  then  pass  safely 
through  the  distemper,  his  system  being  "  cleared 
from  those  obstructions  that  so  often  proved  dangerous 
to  those  who  have  neglected  the  opportunity  of  being 
properly  prepared  for  the  reception  of  the  infectious 
venom."  Individual  temperaments  were  also  taken  into 
account,  as  well  as  age  and  season.  It  was  necessary 
to  be  informed  of  the  exact  state  of  the  patient's 
health,  both  before  and  at  the  time  of  inoculation. 

The  Ope7'ation  and  its  Accidents. — When  the  patient 
was  considered  in  a  fit  state,  the  operation  was 
performed  in  the  following  way  : — An  incision  of 
about  an  inch  long  was  made  on  each  arm  through 
the  cuticle  into  the  skin,  but  not  so  deep  as  to  wound 
the  cellular  membrane.  A  thread,  saturated  with  vario- 
lous  matter,   was  laid   along    the   whole    length   of   the 


58  SMALL   POX  LNOCULA7'I02\. 

wound,  and  covered  with  a  pledget  of  digestive  oint- 
ment, fastened  on  with  a  digestive  plaster  and  secured 
with  a  thin  linen  roller.  This  dressing  was  continued 
for  two  days,  and  on  examining  the  wound  on  the 
third  day,  it  was  found  slightly  inflamed.  Two  or 
three  days  after,  the  edges  of  the  wound  looked 
whitish,  a  certain  sign  that  the  inoculation  had  taken. 
On  the  seventh  day  after  the  operation,  or  soon  after, 
the  patient  experienced  chilliness,  with  slight  shiver- 
ings,  pains  in  the  back  and  limbs,  weight  and  pain  in 
the   head,  and   sickness. 

Young  children  became  drowsy  and  heavy,  and 
sometimes  suffered  from  frequent  convulsions  ;  they  were 
kept  in  bed,  and  supplied  with  warm  liquids,  and  these 
symptoms  gradually  abated,  and  sweating  ensued.  On 
the  second  day  after  the  first  appearance  of  constitutional 
symptoms  a  rash,  resembling  flea-bites,  often  made 
its  appearance,  sometimes  closely  simulating  the  rash 
of  scarlet  fever.  About  the  fourth  day,  all  other 
symptoms  decreasing,  the  variolous  eruptions  com- 
menced as  small  red  spots,  which  by  the  beginning 
of  the  fifth  day  had  risen  apparently  above  the  skin. 
From  this  time  the  pimples  daily  rose  higher,  and 
gradually  changed  from  red  to  a  whitish-yellow  hue, 
till,  on  the  seventh  day  from  the  eruption  on  the  face, 
they  became  pustules  charged  with  matter,  and  by 
the  ninth  day  the  same  alteration  occurred  upon  the 
limbs  ;     from     this     time     all     the     outward     marks     of 


OFERATIOX  AND    TREATMENT. 


59 


inflammation  ceased  entirely,  the  skin  of  the  pustules 
shrivelled,  the  matter  contained  in  them  thickened 
into  a  scab,  and  the  patient  was  out  of  danger. 

This  was  the  regular  course  of  inoculated  Small 
Pox,  but  sometimes  children  suffered  from  diarrhoea, 
adults  with  bleeding  at  the  nose ;  sometimes  much 
more  serious   symptoms   ensued. 

Almiagement  after  Inoailation.  —  The  patient  was 
confined  to  his  apartment  and  carefully  dieted.  If 
there  were  depression  or  nervousness,  a  little  wine  was 
allowed.  On  the  seventh  day,  when  the  constitu- 
tional symptoms  showed  themselves,  the  patient  was 
put  to  bed,  and  any  tendency  to  constipation  was 
corrected  by  means  of  roasted  apples,  currants  boiled 
in  a  bag  and  squeezed  into  water  gruel,  or  fruit  boiled 
in  oatmeal.  If  these  were  insufficient,  a  clyster  was 
administered,  or  a  gentle  purge  given.  When  there 
were  more  severe  symptoms,  the  patients  were  bled 
and  blistered.  When  the  eruption  began  to  appear,  the 
symptoms  were  relieved,  but  the  patient  was  kept  in 
bed  until  after  the  crisis,  and  then  allowed  to  sit  up, 
care  being  taken  to  avoid  a  chill.  Abstinence  from 
solid  animal  diet  was  enforced,  unless  the  attack  was 
very   slight,   in   which  case   fish  was  allowed. 

Accidents  after  Inocidatioii. — Sometimes  open  sores, 
with  central  sloughs,  resulted.  The  slough  often  ex- 
tended in  breadth  and  depth,  and  the  wound  dis- 
charged an  ichorous  pus,  which  corroded   the  adjoining 


6o  SMALL   POX  lAOCULAy/OX 


parts,  and  the  inflammation  extended  down  to  the 
elbow ;  in  others  the  wounds  were  very  well  condi- 
tioned, and  the  dischars^e  moderate.  The  wounds 
often  continued  discharging  about  a  fortnight  or  three 
weeks  after  the  turn  of  the  Small  Pox,  or  even 
longer,  and  then  healed  up  kindly  under  some  simple 
dressing ;  but  poultices  were  sometimes  necessary,  and 
bleeding  and  gentle  purging  resorted  to,  to  encourage 
the  wound   to  heal. 

Failure  of  the  Operation. — Sometimes  it  happened 
that  the  inoculation  did  not  take,  although  it  had  been 
correctly  performed,  and  the  matter  good  and  properly 
taken,  the  incision  healing  in  a  few  days.  In  reference 
to  these  results   Burgess  says  : — 

"  When  this  is  the  case  the  patient  is  not  secure  from  the 
danger  of  contracting  the  disease  afterwards  ;  but  if  the  sores 
keep  open,  and  the  feverish  symptoms  come  on  at  the  usual  time, 
though  not  a  single  pustule  should  appear,  I  am  convinced  that  the 
patient  is  as  secure  from  ever  having  the  Small  Pox  as  if  there  had 
been  a  plentiful  eruption." 

Practice  of  the  Suttons  and  Dimsdale. — The 
extraordinary  popularity  of  the  New  Method,  or  Sut- 
tonian  system,  led  to  much  curiosity  among  physicians, 
and  we  are  indebted  to  Dr.  Baker  tor  the  earliest 
account  of  the  method  employed  by  the  Sutton 
family.  The  details  of  the  management  and  mode  of 
operation  were  obtained  from  informants  who  had 
themselves   been   operated  upon  by   Sutton. 


OPERATION  AND   TREATMENT.  6i 


"  All  persons  are  obliged  to  go  through  a  strict  preparatory 
regimen  for  a  fortnight  before  the  operation  is  performed  ;  during 
this  course,  every  kind  of  animal  food  (milk  only  excepted),  and 
all  fermented  liquors  and  spices,  are  forbidden ;  fruit  of  all  sorts 
is  allowed,  except  only  on  those  days  when  a  purging  medicine 
is  taken.  In  this  fortnight  of  preparation,  a  dose  of  a  powder  is 
ordered  to  be  taken  at  bedtime,  three  several  times ;  and  on 
the  following  mornings,  a  dose  of  purging  salt.  To  children, 
only  three  doses  of  the  powder  are  given,  without  any  purging 
salt.  The  composition  of  this  powder  is  industriously  kept  a 
secret.  But  that  it  consists  partly  of  a  mercurial  preparation,  is 
demonstrated  by  its  having  made  the  gums  of  several  people  sore, 
and  even  salivated  others.  The  months  of  May,  June,  July,  and 
August  are  preferred  as  the  most  seasonable  for  inoculation.  But 
healthy  people  are  inoculated  at  any  season  of  the  year,  indififer- 
entl}'.  The  autumn  is  held  to  be  the  worst  season  ;  and  an  aguish 
habit  the  least  proper  for  this  operation.  No  objection  is  made 
to  any  one  on  account  of  what  is  vulgarly  called  a  scorbutic  habit 
of  body,  or  bad  blood.  .  .  .  The  person  who  is  to  be  inoculated, 
on  his  arrival  at  the  house  used  for  this  purpose  is  carried  into 
a  public  room,  where  very  probably  he  may  meet  a  large  company 
assembled,  under  the  several  stages  of  the  Small  Pox.  The 
operator  then  opens  a  pustule  of  one  of  the  company,  chusing 
one  where  the  matter  is  in  a  crude  state,  and  then  just  raises  up 
the  cuticle  on  the  outer  part  of  the  arm  where  it  is  thickest  with 
his  moist  lancet.  This  done,  he  only  presseth  down  the  raised 
cuticle  with  his  finger,  and  applieth  neither  plaster  nor  bandage. 
What  is  extremely  remarkable,  he  frequently  inoculates  people 
with  the  moisture  taken  from  the  arm  before  eruption  of  the 
Small  Pox,  nay,  within  four  days  after  the  operation  has  been 
performed.  And  I  am  informed,  at  present,  he  gives  the  pre- 
ference to  this  method.  He  has  attempted  to  inoculate  by 
means  of  the  blood,  but  without  success.  If  the  operator  hap- 
peneth  not  to  be  at  home  when  the  new  patient  arriveth,  this 
is  looked  upon  as  a  matter  of  no  importance ;  and  so  far  is 
he  from  any  apprehension  of  accumulating  infection,  that  it  is 
very  common  for  persons  just  inoculated  to  lie  in  the  same 
bed   with   a   patient   under   any  stage   of  the  disease,    as   it   may 


62  SMALL   POX   LNOCULATLON. 


happen  ;    nay,    sometimes,  in   a  room  where   four  or  five  people 
are  sick. 

"  On  the  night  following  the  operation  the  patient  takes  a  pill. 
This  medicine  is  repeated  every  other  night  until  the  fever  comes 
on.  All  this  time,  moderate  exercise  in  the  air  is  strongly 
recommended.  In  twenty  four  hours  after  the  inoculation,  the 
operator  can  often  distinguish  whether  or  no  the  patients  be 
infected.  He,  every  day,  examines  the  incision,  and  from  thence 
seems  to  prognosticate  with  some  degree  of  certainty  concerning 
the  degree  of  the  future  disease.  In  three  days  after  the  operation 
(provided  that  it  has  succeeded),  there  appears  on  the  incision 
a  spot  like  a  flea-bite,  not  as  yet  above  the  skin ;  this  spot  by 
degrees  rises  to  a  red  pimple,  and  then  becomes  a  bladder  full  of 
clear  lymph.  This  advanceth  to  maturation  like  the  variolous 
pustules,  but  is  the  last  which  falleth  off.  In  proportion  as 
the  discoloration  round  the  place  of  incision  is  greater,  the  less 
quantit}'  of  eruption  is  expected.  And,  therefore,  whenever  a 
small  discoloured  circle  is  observed,  purging  medicines  stronger 
than  ordinary,  and  more  frequently  repeated,  are  held  to  be 
necessar}^  There  never  is  any  sore  in  the  arm,  or  discharge, 
but  constantly  and  invariably  a  large  pustule. 

"The  preparatory  diet  is  still  continued.  If  the  fever  remain 
some  hours  without  any  tendency  to  perspiration,  some  acid  drops 
are  administered,  the  effect  of  which  is  to  bring  on  a  profuse 
sweat ;  but,  in  some  cases,  where  the  fever  is  very  high,  a  powder 
or  pill,  still  more  powerful,  is  given.  ...  In  general,  during  the 
burning  heat  of  the  fever,  the  inoculator  gives  cold  water;  but, 
the  perspiration  beginning,  he  orders  warm  Baum  tea,  or  thin 
water  gruel.  As  soon  as  the  sweat  abates,  the  eruption  having 
made  its  first  appearance,  he  obliges  everybody  to  get  up  to 
walk  about  the  house  or  into  the  garden.  From  this  time  to 
the  turn  of  the  disease  he  gives  milk  gruel  ad  libitum.  On  the 
day  following  the  first  appearance  of  the  opaque  spot  on  the 
pustules,  to  grown  people  he  gives  an  ounce  of  Glauber's  purging 
salt.  To  children  he  gives  a  dose  of  it  proportioned  to  their 
age ;  then,  if  the  eruption  be  small,  he  allows  them  to  eat  a 
little  boiled  mutton  and  toast  and  butter,  and  to  drink  small  beer. 
But,   in    case  of  a  large   eruption,    he   gives   them,    on    the   third 


OPERATION  AND   TREATAIENT.  63 


day  after  their  having  taken  the  first  dose,  another  dose  of  the 
same  salt,  and  confines  them  to  the  diet  ordered  during  the 
preparation.   .  .  ■. 

"  What  is  above  written  is  to  be  considered  as  relating  only  to 
the  practice  of  one  gentleman.  There  are  in  different  parts  of 
the  country  several  other  inoculators,  some  of  whom  are  said 
to  have  surpassed  this  person  in  the  boldness  of  their  practice. 
We  have  heard  of  patients  who  have  been  carried  into  the  fields 
while  shivering  in  a  rigor;  of  their  having  been  allowed  no  liquor 
except  what  they  have  been  able  to  procure  for  themselves  at 
the  pump,  while  the  fever  has  been  upon  them  ;  and  of  their 
having  been  indiscriminately  exposed  to  the  air,  in  all  sorts  of 
weather  and  in  all  seasons,  during  every  period  of  the  eruption. 
This  and  more  has  been  related  upon  good  authority ;  and, 
indeed,  it  is  certain  that  many  thousands  of  all  constitutions  and 
ages,  even  to  that  of  seventy  years,  have  within  these  few  3'ears 
been  inoculated  according  to  the  general  method  above  described, 
and  in  general  have  gone  through  the  disease  almost  without  an 
unfavourable  symptom.  According  to  the  best  information  which 
I  can  procure,  about  seventeen  thousand  have  been  thus  inocu- 
lated, of  which  number  no  more  than  five  or  six  have  died." 

Dr.  Baker  was  of  opinion  that  the  value  of  the 
practice  depended  upon  the  free  use  of  cold  air. 
Dr.  Glass,  of  Exeter,  attributed  it  to  the  patient 
being  sweated.  Dr.  Chandler,  who  made  a  minute 
exaniination  of  Dr.  Sutton's  system,  concluded  that  the 
success  of  the  celebrated  inoculator  did  not  depend 
upon  his  medicinal  preparations,  nor  the  free  exposure 
of  his  patients  to  cold  air  ;  Mr.  Sutton  never  made 
a  point  of  sweating  his  patients,  and,  therefore,  but 
little  efficacy  could  be  attributed  to  the  punch  which 
was  given  ;  the  pills  were  useful  merely  as  evacuants, 
and    not   as   possessing   specific  power.      I)Ut   the   grand 


64  SMALL   POX  INOCULATION. 


secret  of  the  new  system  of  inoculation,  according 
to    Mr.    Chandler/    was — 

"  The  taking  of  the  infected  humour  in  a  crude  state  before  it  has 
been,  if  I  may  be  allowed  the  expression,  ultimately  variolated  by  the 
succeeding  fever." 

This  was  confirmed  by  the  Rev.  Mr.  Houlton's 
publication,  in  which  it  was  asserted  that  Mr.  Sutton 
never  brought  into  Chelmsford  a  patient  who  was 
capable  of  infecting  a  bystander,  though  such  patient 
could    convey    infection    by    inoculation. 

In  spite  of  unfavourable  criticisms  which  had  been 
passed  upon  the  Suttonian  method,  Dt.  Dimsdale  ^ 
appreciated  the  satisfaction  which  it  gave  to  the 
public,  and  was  not  slow  to  adopt  the  method  in 
his  own  practice.  He  published  a  work  on  the 
subject,  which  was  to  a  certain  extent  a  rdsumd  of 
the  methods  of  the  Suttons,  but  it  was  not  until 
some  years  afterwards,  that  he  openly  adopted  the 
Suttonian  plan  in  its  entirety.  Dimsdale  laid  con- 
siderable stress  upon  age,  constitution,  and  season. 
It  was  not  considered  desirable  to  inoculate  children 
under  two  years,  from  the  tendency  to  convulsions, 
and  as  they  usually  had  a  larger  share  of  pustules 
than  those  who  are  advanced  in  life,  and  many  had 
died.       Those    who    laboured     under    acute    or    critical 


'  Chandler.     An  Essay  towards  an  invest! gat  1071  of  the  present  suc- 
cessful and  most  general  method  of  Inoculation,  p.  37.     1767. 
^  Dimsdale,  lac.  cit.,  1779. 


OPERATION  AND    TREATMENT. 


diseases  or  their  effects  were  "  obviously  unfit  and 
improper  subjects  ;  "  and  those  who  had  marks  of"  corro- 
sive, acrimonious  humours,"  or  were  suffering  from  "  a 
manifest  debihty  of  the  whole  frame  from  inanition 
or    any    other    cause." 

Dr.  Heberden^  had  some  time  previously,  in  a  com- 
munication to  Dr.  Kirkpatrick,  insisted  upon  attention  to 
the  existence  of  any  disease  at  the  time  of  inoculation, 

"  It  seems  a  reasonable  practice  to  take  some  care  that  at 
the  Time  of  his  Receiving  the  Infection  of  the  Small  Pocks, 
the  Person  should  be  as  free  as  may  be  from  any  other  dis- 
temper, lest  Nature  should  be  hindered  in  producing,  maturating, 
or  rightly  discharging  them  ;  or  lest  he  should  sink  under  the 
oppression  of  two  Distempers  at  the  same  Time." 

All  Dimsdale's  patients  had  to  undergo  special 
treatment  previous  to  the  introduction  of  the  disease. 
Persons  inoculated  in  the  spring  generally  had  more 
pustules  than  at  any  other  time  of  the  year ;  but  it 
was  considered  safe  to  inoculate  at  all  seasons,  pro- 
vided that  care  was  taken  to  keep  the  patients  as 
cool  as  possible  during  the  heat  of  summer,  and  to 
prevent  them  from  keeping  themselves  too  warm 
or  too  much  shut  up  in   winter. 

Preparation. — The  general  aims  of  preparation  were 
to  reduce  the  patient  if  in  high  health,  to  a  low 
state ;  to  strengthen  the  constitution,  if  too  low  ;  and 
to  clear  the  stomach   and    bowels    iis    much   as   possible 

'  Kirkpatrick,  loc  cit.,  p.  271.  '' 

VOL.    I.  S 


66  SMALL   POX  INOCULATION. 

from  "  all  crudities."  The  patients  were  enjoined  to 
abstain  from  all  animal  food,  fermented  liquors,  and 
spices  ;  the  diet  to  consist  of  pudding,  gruel,  sago,  milk, 
fruit,  and  vegetables,  and  care  was  to  be  taken  not 
to  overload  the  stomach.  This  treatment  was  carried 
out  nine  or  ten  days  before  the  operation,  and  during 
this  period  the  patients  were  directed  to  take  a 
powder  composed  of  eight  grains  of  calomel,  the  same 
quantity  of  compound  powder  of  crabs'  claws,  and 
one-eighth  part  of  a  grain  of  tartar  emetic.  Three 
doses  of  this  were  given  ;  one  at  the  commencement 
of  the  course,  the  second  in  three  or  four  days,  and 
the   third   about   the   eighth   or   ninth   day. 

Mode  of  Inoculation. — Dimsdale  had  been  in  the 
habit  of  applying  a  piece  of  thread,  which  had  been 
drawn  through  a  ripe  pustule  and  well  moistened 
with  the  matter,  to  an  incision  in  one  or  both  arms. 
But    this    method   he    had    now    abandoned. 

"  The  patient  to  be  infected  being  in  the  same  house,  and,  if 
no  objection  is  made  to  it,  in  the  same  room,  with  one  who  has 
the  disease,  a  little  of  the  variolous  matter  is  taken  from  the 
place  of  insertion,  if  the  subject  is  under  inoculation,  or  a  pus- 
tule, if  in  the  natural  wa}',  on  the  point  of  a  lancet,  so  that 
both  sides  of  the  point  are  moistened.  With  this  lancet  an 
incision  is  made  in  that  part  of  the  arm  where  issues  were 
usually  placed,  just  deep  enough  to  pass  through  the  scarf  skin, 
and  just  to  touch  the  skin  itself,  and  in  length  not  more  than 
one-eighth  of  an  inch  ;  the  little  wound  being  then  stretched 
between  the  finger  and  thumb  of  the  operator,  the  incision  is 
moistened  with  the  matter  by  gently  touching  it*  with  the  side 
of  the  infected  lancet." 


OPERATION  AND   TREATMENT.  67 


Dimsdale  sometimes  employed  the  following  modi- 
fication : — 

"  A  lancet  being  moistened  with  the  variolous  fluid  in  the  same 
manner  as  the  other,  is  gently  introduced  in  an  oblique  manner 
between  the  scarf  and  true  skin,  and  the  finger  of  the  operator 
is  applied  on  the  point,  in  order  to  wipe  off  the  infection  from 
the  lancet  when  it  is  withdrawn." 

It  was  said  to  be  of  no  consequence  whether 
infective  matter  were  taken  from  the  natural  or  the 
inoculated  Small  Pox.  Dimsdale  used  both,  and 
he  did  not  consider  it  of  consequence  whether  the 
matter  were  taken  before  or  at  the  crisis  of  the 
disease. 

"  It  is,  I  believe,  generally  supposed  that  the  Small  Pox  is 
not  infectious  till  after  the  matter  has  acquired  a  certain  degree 
of  maturity ;  and  in  the  common  method  of  inoculation  this  is 
much  attended  to ;  and  where  the  operation  has  failed  it  has 
commonly  been  ascribed  to  the  unripeness  of  the  matter.  But 
it  appears  very  clearly  from  the  present  practice  of  inoculation, 
that  so  soon  as  any  moisture  can  be  taken  from  the  infected 
part  of  an  inoculated  patient,  previous  to  the  appearance  of  any 
pustules,  and  even  previous  to  the  eruptive  fever,  this  moisture  is 
capable  of  communicating  the  Small  Pox  with  the  utmost  certainty. 
I  have  taken  a  little  clear  fluid,  from  the  elevated  pellicle  on  the 
incised  part,  even  so  early  as  the  fourth  day  after  the  operation, 
and  have,  at  other  times,  used  matter,  fully  digested  at  the 
crisis,  with  equal  success.  I  chuse,  however,  in  general  to  take 
matter  for  infection  during  the  fever  of  eruption,  as  I  suppose 
it  at  that  time  to  have  its  utmost  activity." 

No  bandage,  dressing,  or  application  whatsoever  was 
employed  in  this  method. 


68  SMALL   POX  INOCULATION. 


"Progress  of  Infection.— The  day  after  the  operation  is  per- 
formed, though  it  takes  effect,  little  alteration  is  discoverable.  On 
the  second,  if  the  part  is  viewed  with  a  lens,  there  generally 
appears  a  kind  of  orange  coloured  stain  about  the  incision,  and 
the  surrounding  skin  seems  to  contract.  A  dose  of  the  calomel 
pill  was  given  at  bedtime. 

"  On  the  fourth  or  fifth  day,  upon  applying  the  finger,  a  hard- 
ness is  to  be  felt  by  the  touch.  The  patient  perceives  an  itching 
on  the  part  which  appears  slightly  inflamed,  and  under  a  kind 
of  vesication  is  seen  a  little  clear  fluid,  the  part  resembling  a 
superficial  burn.  About  the  sixth,  most  commonly  some  pain  and 
stiffness  is  felt  in  the  axilla,  and  this  is  a  very  pleasing  symptom, 
as  it  not  only  foretells  the  near  approach  of  the  eruptive  symptoms, 
but  is  a  sign  of  a  favorable  progress  of  the  disease.  Sometimes 
on  the  seventh,  oftener  on  the  eighth  day,  symptoms  of  the 
eruptive  fever  appear,  such  as  slight  pains  in  the  head  and  back, 
succeeded  by  transient  shiverings,  and  alternate  heats,  which  in  a 
greater  or  less  degree  continue  till  the  eruption  is  perfected. 
At  this  time,  also,  it  is  usual  for  the  patient  to  complain  of  a 
very  disagreeable  taste  in  his  mouth,  the  breath  is  always  fetid, 
and  the  smell  of  it  different  from  what  I  have  ever  observed  in 
any  case,  except  in  the  variolous  eruptive  fever. 

"  The  inflammation  in  the  arm,  at  this  time,  spreads  fast,  and 
upon  viewing  it  with  a  good  glass,  the  incision,  for  the  most  part, 
appears  surrounded  with  an  infinite  number  of  small  confluent 
pustules,  which  increase  in  size  and  extent  as  the  disease 
advances.  On  the  tenth  or  eleventh  day,  a  circular  or  oval 
efflorescence  is  usually  discovered  surrounding  the  incision,  and 
extending  sometimes  near  half  round  the  arm  ;  but,  more  fre- 
quently, to  about  the  size  of  a  shilling ;  and  being  under  the 
cuticle  is  smooth  to  the  touch,  and  not  painful.  This  appearance 
is  also  a  very  pleasing  one  ;  it  accompanies  eruption,  every 
disagreeable  symptom  ceases,  and  at  the  same  time  it  certainly 
indicates  the  whole  aflfair  to  be  over,  the  pain  and  stiffness  in  the 
axilla  also  going  off.  The  feverish  symptoms  are,  for  the  most 
part,  so  mild  as  seldom  to  require  any  medicinal  assistance,  except 
a  repetition  of  the  same  medicine  that  was  directed  on  the  second 
night  after  the  operation,  and  in  the  morning,  this  laxative  draught 


OPERATION  AND   TREATMENT.  69 

to   procure   three  or   four  stools  ;    infusion  of  senna  two  ounces, 
manna  half  an  ounce,   tincture  of  jalap  two  drams.   .   .   . 

"  Being  now  arrived  at  the  most  interesting  period  of  this 
tlistemper,  the  eruption,  a  period  in  wliich  the  present  practice 
I  am  about  to  recommend  differs  essentially  from  the  method 
heretofore  in  use,  and  on  the  right  management  of  which  much 
depends,  it  will  be  requisite  to  give  clear  and  explicit  directions 
on  this  head,  and  to  advise  their  being  pursued  with  firmness  and 
moderation.  Instead  of  confining  the  patient  to  his  bed  or  his 
room  when  the  symptoms  of  the  eruptive  fever  come  on,  he  is 
directed,  as  soon  as  the  purging  medicine  has  operated,  to  keep 
abroad  in  the  open  air — be  it  ever  so  cold,  as  much  as  he  can 
hear — and  to  drink  cold  water  if  thirsty  ;  always  taking  care  not 
to  stand  still,  but  to  walk  about  moderately  while  abroad.  .  .  . 

"  In  general  the  complaints  in  this  state  are  very  moderate, 
and  attended  with  so  little  illness  that  the  patient  eats  and  sleeps 
well  the  whole  time ;  a  few  pustules  appear,  sometimes,  equall}' 
dispersed  ;  sometimes  the  inflammations  on  the  arms  spread  and 
are  surrounded  with  a  few  pustules,  which  gradually  advance  to 
maturity,  during  which  time,  for  the  most  part,  the  eruption  pro- 
ceeds kindly,  and  there  is  much  more  difficult^'  to  restrain  the 
patients  vi^ithin  due  bounds,  and  to  prevent  their  mixing  with 
the  public  and  spreading  the  infection  (which  I  always  endeavour 
to  prevent),  than  there  was  at  first  to  prevail  upon  them  to  go 
abroad. 

"The  system  of  purging  and  the  free  use  of  cold  air  were 
credited  with  preventing  either  alarming  symptoms,  or  a  large 
crop  of  pustules.  Those  who  had  the  disease  in  the  slightest 
manner — that  is  to  say,  without  any  appearance  of  eruption  except 
on  the  inoculated  part — were  soon  allowed  to  go  about  their  usual 
affairs.  Those  who  had  it  in  a  greater  degree  were  confined  a 
little  longer.  Occasionally  there  were  dangerous  symptoms,  and 
accidents  of  various  kinds.  Sometimes  the  inoculated  part  showed 
certain  marks  of  infection  a  day  or  two  after  inoculation,  the 
incision  appearing  considerabl}^  inflamed  and  elevated. 

"The  patient  about  this  time  frequently  makes  some  of  the 
following  complaints  :  viz.,  chilliness ;  itchings  and  small  pricking 
pains  in   the   part,   and    sometimes    in    the    shoulder ;    giddiness, 


70  SMALL   POX  IN0CULA210N. 

drowsiness,  and  a  slight  headach,  sometimes  attended  with  a 
feverish  heat,  but  often  without  any.  .  .  .  These  complaints 
seldom  last  twenty-four  hours,  often  not  so  long.  .  .  .  The 
inflammation  on  the  arm,  at  the  time  of  the  complaint,  advances 
apace,  and  feels  hard  to  the  touch  ;  but,  upon  their  wearing  off, 
the  inflamed  appearances  gradually  lessen,  and  the  part  dries 
to  a  common  small  scab  ;  the  skin  that  was  before  red  turns  livid, 
and  the  party  is  quite  well,  and  nothing  more  is  heard  of  the 
distemper.  .   .  . 

"  In  some  instances,  these  symptoms  attack  much  later ;  even 
on  the  seventh  or  eighth  day,  when  an  eruption  might  be  expected 
in  consequence  of  them,  yet  none  appears ;  but  the  arm  gets  well 
very  soon,  and  the  disease  is  at  an  end." 

Similar  appearances  resulted  in  other  cases,  though 
there  were  only  a  few  pustules  which,  moreover,  did 
not  look  like  true  pocks.  When  such  cases  first 
occurred  in  Dimsdale's  practice,  he  was  in  doubt 
whether  the  patients  would  be  quite  secure  in  fijture 
from  an  attack  of  the  disease  ;  and,  in  order  to  test 
whether  they  were  so,  he  inoculated  them  a  second 
time,  and  caused  them  to  associate  with  persons  in 
every  stage  of  the  disease,  and  exposed  them  to  all 
other  means  of  catching  the  infection  ;  but  there  was 
no  instance  of  its  producing  any  disorder,  so  that  they 
were  pronounced  to  be  perfectly  safe. 

Dimsdale  explained  how  it  was  that  he  was  led  to 
try  the  new  method  of  inoculation  in  1765.  He  had 
heard  that  inoculation  of  the  patients  with  fluid  matter, 
and  exposure  to  the  open  air,  produced  results  that 
were  appreciated,  and  therefore  he  borrowed  the 
practice.      He    concluded    by    saying : — 


OPERATION  AND   TREATMENT.  71 


"  Should  it  be  asked,  then,  to  what  particular  circumstance  the 
success  is  owing,  I  can  only  answer  that,  although  the  whole 
process  may  have  some  share  in  it,  in  my  opinion  it  consists 
chiefly  in  the  method  of  inoculating  with  recent  jhiid  matter,  and 
in  the  management  of  the  patients  at  the  time  of  eruption.  If 
these  conjectures  should  be  true,  perhaps  we  should  be  found  to 
have  improved  but  little  upon  the  judicious  Sydenham's  cool  method 
of  treating  the  disease,  and  the  old  Greek  woman's  method  of  in- 
oculating with  fluid  matter  carried  warm  in  her  servant's  bosom." 

Dimsdale  now  became  recognised  as  a  specialist  in 
the  art  of  inoculation.  He  was  summoned  to  Russia, 
in  1768,  to  inoculate  the  Empress,  and  his  procedure 
may  be  followed  in  some  detail,  as  the  results  led  to 
the  revival  of  inoculation  in  England.  Dimsdale,  on 
arrival  at  St.  Petersburg,  resolved  to  commence  opera- 
tions by  experimenting  on  two  young  gentlemen  of 
the  Cadets  Corps. ^  These  boys,  Basoff  and  Swieten, 
were  about  fourteen  years  old.  The  matter  for  their 
inoculation  was  taken  from  a  child  of  a  poor  man  in 
the  suburbs  of  St.  Petersburg,  who  was  "  pretty  full 
of  a  distinct  kind  of  Small  Pox."  Every  one  was 
anxious  for  the  success  of  this  first  attempt,  and  the 
experiment  caused  Dimsdale  considerable  anxiety.  On 
the  second  day  after  inoculation,  Basofi"  was  seized 
"  with  great  sickness  and  vomiting,"  attended  with 
other  symptoms  of  fever ;  but  it  was  subsequently 
"  discovered  that  he  had  improperly  overcharged  his 
stomach   with  a  quantity   of  dried   fruits,   which   it   was^ 


'  Dimsdale.     Tracts  on   Inoculation   writtoi    and  published  at    St. 
Petersburg  in  the  year  1768,  zi}ith  adclitio7ial  observations.     1781. 


^2  SMALL   FOX  INOCULATION. 

hoped  might  be  the  sole  occasion  of  that  disorder." 
Dimsdale's  anxiety  was  reheved,  for  the  symptoms  of 
the  eruptive  fever  were  moderate,  and  only  two  or 
three  pustules  followed  on  the  arm,  Swieten's  arm, 
which  had  never  seemed  likely  to  produce  any  eruption, 
remained  well.  Four  more  youths  of  the  Cadets  Corps 
and  a  young  maid-servant  were  selected  for  further 
trials,  and  a  case  of  natural  Small  Pox,  with  the  eruption 
in  a  suitable  stage  for  the  purpose,   was  chosen. 

"  The  child  from  whom  we  were  to  take  matter  for  inoculation 
was  ratlier  full  of  Small  Pox,  the  kind  was  favourable  and  dis- 
tinct, and  near  the  time  of  maturation.  .   .  . 

"As  we  were  extremely  anxious  for  the  event  of  this  inocula- 
tion, our  observations  were  carefully  and  frequently  made  on  the 
progress  of  it  in  the  five  patients  ;  ...  on  the  punctured  part 
almost  immediately  arose  a  pimple,  which  scon  became  one  large 
pustule  filled  with  yellow  matter,  very  much  resembling  the  Small 
Pox  completely  maturated.  This  continued  to  the  seventh  and 
eighth  days,  when  the  eruptive  symptoms  might,  in  the  common 
course,  be  expected.  Not  one  of  them,  however,  had  any  illness, 
nor  did  I  then  expect  they  would,  and  in  short  the  experiment 
turned  out  wholly  ineffectual.  The  wounds  upon  the  arms  dried 
up,  and  the  patients  continued  in  perfect  health." 

Dimsdale  was  strongly  disposed  to  believe  that 
these  patients  had  passed  through  Small  Pox  at  some 
early  period  of  their  lives,  but  no  evidence  whatever 
existed  in  support  of  this  theory.  He  proposed  that 
the  same  persons  should  be  inoculated  a  second  time 
in  the  old  and  original  manner.  The  patients  were  | 
also    recommended     to    frequent    the     rooms    of    those 


OPERA  TIOX  A  A' 7.)   TREATMENT. 


7i 


who  were  under  the  natural  Small  Pox,  even  of  the 
worst  sort  ;  that  they  should  handle  those  labouring 
under  Small  Pox,  and  expose  themselves  in  every 
way  to  infection.  This  proposal  was  carried  into 
execution,  but  the  result  was  that  not  the  least 
symptom    of    infection    was    produced. 

The   Empress  was  now  determined    to  undergo    ino- 
culation.      A    child     "  on     whom    the     Small    Pox  had 
just   commenced  to    appear''  was  selected  and  taken  to 
the  palace.      The  operation  was  secretly  performed. 

"  The  Empress,  during  this  interval,  took  part  in  every  amuse- 
ment with  her  usual  afitability,  without  showing  the  least  token  of 
uneasiness  or  concern,  constantly  dined  at  the  same  table  with 
the  nobility,  and  enlivened  the  whole  Court  with  those  peculiar 
graces  of  conversation  for  which  she  is  not  less  distinguished  than 
for  her  rank  and  station." 

Dimsdale  also  recommended  inoculation  of  the  Grand 
Duke,  if  it  were  performed  by  a  very  slight  puncture 
of  a  lancet  luet  with  recent  and  fluid  variolous  matter, 
as  some  anxiety  was  felt  about  the  state  of  his  health. 
After  relating  these  facts  and  occurrences,  Dimsdale 
remarks  : — 

"  But  I  must  not  omit  mentioning  that  both  the  Empress  and 
the  Grand  Duke  were  pleased  to  permit  several  persons  to  be 
inoculated  from  them,  and,  by  this  condescension,  the  prejudice 
which  had  reigned  among  the  inferior  ranks  of  people,  that  the 
party  would  suffer  from  whom  the  infection  was  taken,  was  most 
effectually  destroyed." 

For  these  services,   Dimsdale  was  made  a    Baron    of 


74  SMALL   POX  INOCULAllON. 

the  Russian  Empire,  appointed  Councillor  of  State, 
Physician  to  Her  Imperial  Majesty,  and  awarded  a 
sum  of  ^10,000  in  addition  to  an  annuity  of  ^500. 

The  following  is  a  short  account  of  the  progress  of 
inoculation  of  the   Empress  : — 

Previous  to  inoculation  she  abstained  "  from  animal  food  at 
supper,  and  at  dinner  ate  such  only  as  was  easy  of  digestion." 
The  day  before  inoculation  "  she  took  5  grains  of  mercurial 
powder."  Sunday^  12th,  late  in  the  evening,  she  was  inoculated 
with  fluid  matter  by  one  puncture  in  each  arm,  and  "on  the 
succeeding  night  was  very  restless,  and  complained  of  pains  in 
different  parts  of  her  body."  .  .  .  On  the  14th,  "  she  passed  a 
tolerable  night,  certain  signs  of  infection  appeared  on  the  places 
of  incision ;  a  little  pain  was  felt  under  the  arm."  .  .  .  On 
October  15th,  "the  giddiness  and  the  pain  under  her  arm  ceased. 
The  places  of  incision  became  more  red."  On  the  i6th,  she 
"complained  of  heaviness  in  her  head  at  intervals;  .  .  .  four  grains 
of  the  mercurial  powder  were  given;"  on  the  17th,  "she  took  half 
an  ounce  of  Glauber's  salt  dissolved  in  warm  water,  but  in  the 
evening  she  complained  of  a  pain  in  her  head,  and  that  her  hands 
and  shoulders  seemed  benumbed,  and  she  was  inclined  to  sleep. 
.  .  .  The  places  of  incision  advanced  properlj^,  and  with  the 
assistance  of  a  magnifying  glass  I  could  plainly  discover  small 
pimples  around  the  part."  On  the  i8th,  "the  incisions  in  the  arm 
became  more  red  and  inflamed."  On  the  19th,  "the  incisions 
looked  more  red,  and  in  the  evening  many  of  the  pimples  men- 
tioned before  appeared  to  unite  in  a  general  inflammation."  About 
the  20th,  "  more  pustules  appeared  around  the  incision,  and  the 
circumference  of  the  wound  itself  looked  more  red  than  before. 
One  pustule  was  also  discovered  in  the  face  and  two  upon  the 
wrist."  October  2 1  St,  "some  pustules  appeared  on  the  face  and 
arms,  and  the  fever  was  entirely  gone."  22nd,  "more  pustules 
appeared,  and  advanced  according  to  our  wishes."  On  October 
24th,  there  was  "a  large  pustule  on  the  upper  part  of  the  right 
tonsil."  25th,  "the  pain  and  swelling  of  the  throat  were  abated; 
.   .  .  some  of  the  pustules  began  to  change  their  colour  to  a  darker 


OPERATION  AXD   TREATMENT. 


75 


hue."  October  27th,  "all  the  pustules  had  now  become  brown." 
On  October  28th,  "  she  returned  to  St.  Petersburg  in  perfect 
health,   to   the  great  joy  of  the   whole   city." 

The  case  of  His  Imperial  Highness  the  Grand 
Duke  was  still   milder. 

"  The  inoculation  was  performed  on  him  with  fresh  fluid  matter, 
by  one  puncture  in  the  right  arm  only ;  the  matter  was  taken 
from  the  youngest  son  of  Mr.  Briscorn,  apothecary  to  the  Court. 
.  .  .  November  4th,  symptoms  of  infection  appeared  on  the  arm. 
.  .  .  November  5th,  on  examining  the  incision,  the  mark  of  the 
infection  very  evidently  appeared,  and  he  complained  of  the  part 
around  the  wound  being  somewhat  painful.  .  .  .  November  6th, 
he  had  shivering,  succeeded  by  a  feverish  heat  ;  the  quickness  of 
the  pulse  increased.  .  .  .  November  7th,  he  had  slept  the  preced- 
ing night  ...  a  considerable  shivering.  November  9th,  one 
pustule  appeared  upon  the  chin,  and  three  were  discovered  upon 
the  back.  November  loth,  more  pustules  appeared  on  different 
parts ;  and  he  was  quite  free  from  complaints.  .  .  .  November 
1 2th,  his  throat  was  sore  and  painful.  November  14th,  his  throat 
much  better.  From  this  time  he  was  quite  free  from  pain  ;  the 
pustules,  which  together  did  not  exceed  forty,  matured  kindly,  soon 
dried  up,  and  the  illness  terminated  very  happily." 

At  the  request  of  the  Empress,  Dr.  Dimsdale  pro- 
ceeded to  Moscow,  where  the  citizens  were  desirous 
of  receiving  the  inoculation. 

"  I  was  informed  that  at  Mosco,  as  well  as  at  St.  Petersburg, 
every  possible  precaution  was  used  to  prevent  the  spreading  of 
the  Small  Pox,  and  it  was  very  probable  that  much  time  might  be 
lost  before  the  disease  could  be  discovered  there  in  a  proper  state 
for  inoculation.  I  therefore  thought  it  advisable  to  make  use  of 
an  expedient  that  was  thought  pretty  extraordinary  :  it  was  to 
inoculate  one  or  two  children  at  St.  Petersburg  to  take  with  us,  to 
answer  the  purpose  of  infection  when  we  should  arrive  at  Mosco. 


;6  SMALL   L^OX  INOCULATION. 

It  was  with  some  difficulty  that  two  children  were  procured,  for 
though  the  idea  of  arbitrary  power  conveys  with  it  a  presump- 
tion that  nothing  more  would  be  wanting  than  an  Imperial  order 
for  us  to  fix  on  the  persons  we  thought  most  eligible,  yet  such 
mildness  and  benevolence  prevails  under  the  Government  of  the 
Empress,  that  no  such  compulsion  is  ever  practised.  After  a  few 
days,  two  children  were  obtained,  the  one  a  boy  about  six  years 
old,  the  son  of  a  sailor's  widow,  the  other  a  girl  about  ten,  the 
daughter  of  a  deceased  subaltern  German  officer.  .  ,  .  The 
children  were  inoculated  at  St.  Petersburg  two  days  before  the 
time  fixed  for  our  setting  out,  and  as  it  was  expected  that  the 
journey  would  be  performed  in  four  da3's,  we  hoped  to  arrive  at 
Mosco  on  the  6th  after  inoculation.  .   .  . 

"  Many  of  the  nobility  instantly  applied  to  have  their  families 
inoculated,  and  as  the  patient  that  we  brought  with  us  was  at  that 
time  in  a  very  proper  state  to  take  matter  from,  wc  began  to 
inoculate  on  the  day  after  our  arrival,  so  that  in  a  few  days  we 
had  inoculated  more  than  fifty  patients  from  that  girl  only.  After 
the  first  were  recovered,  several  others,  encouraged  by  their 
success,    were   desirous  of  being   inoculated   also." 

Dimsdale  published  his  experiences  in  Russia,  in 
1 78 1 ,  and  appended  a  description  of  the  points  in 
which,  as  the  result  of  further  experience,  he  had 
modified  his  early  practice.  With  regard  to  the 
method  of  preparation,  he  had  come  to  the  conclusion 
that  such  was  hardly  necessary  ;  and  he  stated  that 
for  some  years  past  he  had  not  been  in  the  habit 
of  enjoining  any  restriction  from  diet,  or  prescribing 
any  special  medicine  before  the  operation,  and  more 
caution  was  exercised  in  repeatedly  giving  mercurials 
or  other  purgatives.  With  regard  to  the  mode  of 
infection,  he  now  restricted  himself  to  inoculating  by 
means    of  a    lancet,    the    point    of    which    was    slightly 


OPERATION  AND  TREATMENT.  77 


t lipped  in  recent  variolous  matter  taken  during  the 
eruptive  fever.  The  lancet  was  introduced  obliquely 
beneath  the  superficial  skin,  making  the  smallest  punc- 
ture possible,  If  there  were  no  patients  in  a  proper  state 
to  yield  the  variolous  fiuid,  dried  lymph  was  employed. 
A  lancet,  or  a  plate  of  glass  or  gold,  was  charged  with 
matter  in  a  fluid  state,  which  was  then  allowed  to  dry, 
When  required  for  use  it  was  held  over  the  steam 
of  boiling  water,  or  a  small  qucUitity  of  water,  barely 
sufficient  for  dilution,  was  added  to  it,  and  the  matter 
thus  moistened  was  used  for  the  purpose  of  inocula- 
tion. The  practice  of  going  out  in  the  fresh  cool  air, 
and  the  use  of  aperients  were  still  recommended  ; 
but,  when  the  complaint  was  moderate,  a  result  which 
he  always  endeavoured  to  obtain,  these  injunctions 
were   dispensed   with. 

Sometimes  patients  under  inoculation  passed  through 
the  illness  in  a  manner  that  differed  materially  from 
natural    Small   Pox. 

"  Yet,  where  the  infection  appeared  to  have  succeeded  satisfactorily 
on  a  punctured  part  of  the  arm,  although  no  eruption  should  be 
discovered  in  consequence  of  it,  the  party  will  never  receive  the 
disease  in  future." 

In  speaking  of  the  different  methods  of  commu- 
nicating the  infection  employed  by  inoculation, 
Dimsdale    states  : — 

"  That  if  inoculation  be  performed  by  a  slight  puncture,  and 
with  fluid  matter,  the  progress  is  usually  this : — After  two, 
three,  or  four  days   a   small  redness  of  a  particular  colour  may 


78  SMALL   POX  INOCULATION. 


be  distinguished,  which  gradually  rises  to  a  pimple,  resembling  the 
Small  Pox  in  its  first  appearance ;  this  fills  with  a  pellucid  fluid. 
About  the  time  of  the  commencement  of  the  eruptive  symptoms, 
the  inflammation  increases,  very  often  during  the  fever. 

"  Now,  when  this  gradual  progress  is  observed  to  take  place, 
I  maintain  that,  although  it  be  unattended  with  fever  or  derange- 
ment of  health,  and  not  followed  by  any  eruption,  the  person 
will  during  the  remainder  of  his  life  be  secure  from  receiving 
the  disease.  I  am  emboldened  to  speak  in  this  positive 
manner  from  having  made  repeated  trials  to  infect  such 
patients  again,  and  in  every  instance  ineffectually." 

Finally,  after  discussing  the  old  method  of  treat- 
ment, Dimsdale  proceeded  to  give  the  credit  of  this 
more  successful  system  to  the  family  of  the  Suttons  ; 
the  essential  difference  between  them  consisting  in  the 
return  to  the  original  method  of  slight  puncture,  and 
the  use  of  recent  fluid  matter.  The  accounts  of  the 
wonderful  effects  of  medicines,  which  were  also  alleged 
to  cure  the  most  malignant  kind  of  Small  Pox  after 
the  eruption  had  appeared,  served  to  disguise  the  true 
secret  of  the  new  method. 

Many  years  afterwards,  Sutton'  published  an  account 
of  the  practice  which  he  had  introduced.  His  method 
had  been  carried  out  in  100,000  cases.  He  acknow- 
ledged that  he  had  relied  upon  the  use  of  crude 
fresJi  matter;  for  in  his  experience  with  concocted 
matter.  "  the  infection  was  not  so  rapid  ;  the  indica- 
tions on  tht:  arm  not  so  favourable ;  the  conglobate 
glands     in    the    axilla    were    more    liable    to    suppurate  ; 


'  Sutton.     The  Iiiociilafoi-,   or   the  Suttonian   system   of  i7iociilatio7i 
fully  set  forth.     1763. 


OPERATION  AND    TREATMENT.  79 


cind  the  eruptive  symptoms  were  more  irregular  and 
ungovernable,"  In  fact,  the  patient  in  all  likelihood 
encountered  "  a  very  copious  Small  Pox,  which  he 
would   not  have  had  from   the   use   of  fresh   matter." 

Sutton  describes  the  method  which  he  employed 
in    the    following    words  : — 

"  The  lancet  being  charged  with  the  smallest  perceivable 
quantity  (and  the  smaller  the  better)  of  unripe,  crude,  or  watery- 
matter,  immediately  introduce  it  by  puncture,  obliquely,  between 
the  scarf  and  true  skin,  barely  sufficient  to  draw  blood,  and 
not  deeper  than  the  sixteenth  part  of  an  inch.  Neither 
patting,  nor  daubing  of  the  matter,  in  or  over  the  punctured 
part,  is  at  all  necessary  to  its  efficacy.  This  practice  indeed  is 
rather  prejudicial  than  otherwise,  as  it  may  affect  the  form  of  the 
incision,   and  thus  be  apt  to  confound  our  judgment  upon  it. 

^^Indications  of  the  Incision. — In  the  incipient  state  of  variolous 
increase  in  the  incision,  a  small  florid  spot  appears  on  the  part  of 
access,  resembling  a  flea-bite  in  size  ;  and  on  passing  the  finger 
lightly  over  it,  a  hardness  is  felt  not  larger  than  a  small  pin's 
head.  This  florid  appearance  and  hardness  denote  that  the 
variolous  principle  is  effectually  imbibed,  and  their  indications 
point  no  farther,  unless  the  progress  to  vesication  be  very  slow, 
in  which  case  an  uncomfortable  number  of  pustules  may  be 
e.xpected  to  follow.  The  florid  spot  in  most  instances  of  inocu- 
lation is  somewhat  larger,  or  more  extended,  on  the  second  than 
on  the  third  day  after  the  insertion. 

"  About  the  fourth  day  from  inoculation,  should  the  incision 
begin  to  vesicate,  an  itching  sensation  will  be  complained  of  on 
the  place  of  insertion  ;  the  occurrence  of  which  symptom  is  the  first 
indication  of  a  favourable  event,  yet  not  of  sufficient  importance  to 
justify  any  present  relaxation  in  the  preparator}^  proceedings. 

The  vesication  of  the  incision  in  most  instances  will  begin  to  be 
visible  on  the  fourth  or  fifth  day  after  the  insertion  of  the  matter  ; 
the  sooner  it  becomes  so,  the  more  favourable  may  be  expected  to 
be  the  event.     The  extent  or  diameter  of  the  vesication  at  this 


8o  SMALL  POX  INOCULATION. 

stage  does  not  usually  exceed  that  of  a  large  pin's  head,  and  it 
has  invariably  a  dint  or  small  depression." 

It  is  interesting  to  note  that  Sutton  frequently  met 
with  cases  of  insusceptibihty.  There  were  one,  two,  or 
three  persons  every  day  w^ho  could  not  be  infected.  In 
such  cases  the  result  of  inoculation  is  thus  described  :— 

"  In  a  few  hours  after  the  insertion  of  the  Small  Pox  matter,  the 
part  became  considerably  inflamed  and  hardened  to  the  extent  of 
a  shilling,  or  wider,  resembling  the  effects  produced  by  the  stings 
or  bites  of  small  venomous  insects,  and  attended  with  an  itching 
sensation.  These  effects  increasing,  continued  for  two,  three,  four, 
or  more  days,  and  then  disappeared.  In  some  instances  of  this 
sort,  which  have  since  happened  to  me,  the  part  thus  irritated  has 
suppurated,  and  a  small  sloughing  ensued  ;  but  this  matter  will  not 
give  the  Small  Pox." 

However,  instances  sometimes  occurred  of  accidents 
and  even  death  ;  but  these  were  attributed  to  other 
causes,  in  order  to  save  the  new  method  from  reproach, 
a  fact  which  was  many  years  afterwards  commented 
upon   by    Moore  ^   in  the  following    words  : — 

"  An  empiric  never  hesitates  at  making  positive  declarations, 
and  is  never  at  a  loss  for  pretexts  to  cover  failures.  Should  an 
infant  at  the  accession  of  the  variolous  fever  be  carried  off  by 
convulsion,  he  denies  with  effrontery  that  the  Small  Pox  was  the 
cause,  and  invents  another  upon  the  spot.  Should  the  confluent 
Small  Pox  and  death  ensue,  he  soon  detects  that  his  instructions 
were  not  strictly  complied  with,  but  some  important  error  was 
committed  in  regimen  ;  or,  that  the  patient  was  too  much  or  too 
little  exposed  to  the  air.  In  fine,  the  fault  may  be  in  the  parents, 
in  the  nurse,  or  in  the  inoculated,  but  is  never  allowed  fairly  to 
fall  upon  the  inoculator." 

'  Moore.      'J7/C  History  of  the  Small  Pox,  p.  269.     1815. 


CHAPTER    IV. 

nAYGARTHS  SYSTEM  FOR    PREVENTING  SMALL    POX. 

The  history  of  Small  Pox  inoculation  has  been  given 
in  the  preceding  pages,  from  its  first  employment 
in  England  to  the  time  of  the  general  adoption 
of  the  Suttonian  method.  This  practice,  though  so 
Ions:  continued,  had  not  only  failed  to  externiinate 
Small  Pox,  but,  on  the  contrary,  there  can  be  little 
doubt  that  it  actually  assisted  in  spreading  the  dis- 
ease. Instances  occurred  in  which  Small  Pox  was 
introduced  by  inoculation  into  towns  which  were  and 
had  been  for  many  years  perfectly  free  from  the 
natural  disease,  and    an    epidemic   followed. 

The  futility  of  inoculation  led  Dr.  Haygarth  in  1777 
to  suggest  a  new  plan  for  exterminating  Small  Pox. 
In  the  year  1784,  he  published  a  work  on  this  sub- 
ject,^ explaining  his  reasons  and  the  means  by  which 
he  proposed  to  carry  out  his  scheme.  It  will  be  ot 
interest  to  follow  his  arsfument  and  conclusions,  which 
resulted    in  his  anticipating,   by    nearly    a   century,    the 


Haygarth.     An  Inquiry  hoiv  to preveijf  the  Small  Pox.     17J 
VOL.  I.  6 


82  PREVENTION  OF  SMALL   FOX. 

modern  method  of  stamping  out  infectious  diseases. 
Haygarth  pointed  out,  first,  that  Small  Pox  is  an 
infectious  distemper  ;  secondly,  that  Small  Pox  was 
never  known  since  its  original  commencement  to  be 
produced    by    any    other    cause  than   infection. 

"  That  at  present  it  is  occasioned  by  neither  cHmate,  soil,  nor 
season,  but  by  infection  only.  The  world  had  existed  about 
four  or  five  thousand  years  before  history  takes  any  notice  of 
this  distemper.  It  is  universally  allowed  to  have  been  originally 
endemic  in  or  near  Arabia.  All  Europe  was  infected  from  this 
place,  and  all  other  parts  of  the  world  that  were  then  known,  or 
have  since  been  discovered.  It  did  not  appear  in  Greenland  till 
^7?)Z-  JThe  infection  was  carried  thither  by  a  native  returning 
home,  in  the  distemper,  from  Copenhagen.  In  Minorca,  it  entirely 
disappeared  from  1725  to  1742^ that  is,  for  seventeen  years.  In 
1745,  it  was  again  brought  to  Minorca  by  one  of  His  Majesty's 
ships  ;  and  there  can  be  no  doubt  that  the  former  infection  was 
imparted  by  some  ship,  though  unnoticed  by  the  author.  At 
Boston,  in  New  England,  the  Small  Pox  had  been  epidemical 
only  eight  times  from  the  first  settlement  of  the  province  of 
Massachusetts  till  1752,  as  appears  from  the  following  tablcr 
composed  out  of  Dr.  Douglas's  Historical  and  Political  Sunuiia/y 
of  North  America. 

Epidemical  Small  Pox  Years 

AT  Boston.  absent. 

1649 — 

1666  ......        17 

1678 12 

1689 11 

1702 13 

^1^"^ 19 

^11^ 9 

1752 22 

"Before  the  epidemic  of  172 1,  the  Small  Pox  was  imported 
from  Barbadoes,  before  that  of  1730,  from  Ireland,  and  before 
that  of  1752,  from   London.     At  Rhode    Island,  in  America,  this 


HAYGARTH'S  SYSl^EM.  83 


distemper  was  never  epidemical,  according  to  authentic  intelligence 
which  I  have  received  from  Dr.  Moffat,  who  practised  physic  at 
Newport,  their  capital,  from  1740  to  1765,  and  from  Dr.  Water- 
lioiise,  a  native  of  the  island.  The  former  gentleman  acquainted 
me  with  this  fact  in  these  words : — '  The  Small  Pox  was  never 
epidemical  during  my  residence  in  Rhode  Island,  nor  before,  that 
1  ever  heard  of  As  far  as  I  can  recollect,  there  never  was,  at  the 
same  time,  more  than  five  or  six  ill  of  the  distemper.  Such  a 
happy  exemption  is  accomplished  by  regulations  established 
there  for  the  purpose.'  " 

Haygarth  was  unable  to  obtain  a  sufficient  number 
of  facts  to  ascertain  with  certainty  on  which  day  of 
the  disease  a  patient  becomes  infectious  ;  but  the 
following  evidence,  he  considered,  would  warrant  a 
probable  conjecture  that  the  patient  is  seldom  or 
never  liable  to  communicate  the  disease  before  the 
eruption    appears. 

"  \st  and  2nd  Cases. — I  attended  a  little  boy,  in  the  Small  Pox, 
whose  eruptions,  of  the  distinct  kind,  appeared  on  the  fourth  day 
of  the  iever.  His  two  sisters,  on  their  appearance,  were  removed 
out  of  the  house.  One  of  them  became  feverish  on  the  eleventh 
day  after  her  removal,  the  other  was  not  attacked  till  seven  weeks 
after,  on  being  exposed  to  another  infection.  As  the  former  sister 
was  only  removed  to  a  neighbouring  house,  there  may  be  some 
doubt  whether  she  might  not  be  infected  by  some  future  com- 
munication.    The  other  was  sent  to  a  much  greater  distance. 

"  T,rd  and  4.1/1  Cases. — A  gentleman's  child  became  feverish  on 
the  Sunda}' ;  two  others  of  his  children  were  daily  in  the  same 
room,  and  one  of  them  lay  every  night  with  the  patient  till 
Friday,  the  sixth  day,  and  were  then  removed  ;  yet  neither  were 
infected,  though  the  pustules  had  appeared  a  day  or  two  before. 
One  of  them  was  inoculated  soon  after  and  had  the  distemper. 

"  5^^'  Case. — In  a  family  where  there  were  four  children  who 
had    never    been    exposed    to    the    infection,    when    the    eruption 


84  PREVENTION  OF  SMALL   POX. 


appeared  on  the  first  patient,  which  was  on  the  fourth  da}^  of 
the  disease,  the  other  three  were  separated  from  it  ^nd  escaped 
infection." 

As  these  observations  were  not  sufficiently  numerous 
to  establish  the  truth,  Haygarth  quoted  the  testimony 
of  Dr.  Heberden,  in  confirmation  of  the  theory  he  had 
advanced.  This  authority  made  the  following  statement 
in  a  letter  to   Haygarth  : — 

"  Many  instances  have  occurred  to  me  which  show  that  one 
who  never  had  Small  Pox  might  safely  associate,  and  even  lie 
in  the  same  bed,  with  a  variolous  patient  for  the  two  or  three 
first  days  of  eruption  without  receiving  the  infection." 

From  this  and  other  experience,  Haygarth  was  of 
opinion   that   it  was  quite  established — 

"  That  when  one  person  is  accidentally  seized  with  the  Small 
Pox  in  a  family  where  others  are  liable  to  it,  the  rest  may 
generally  avoid  the  natural  infection  either  by  separation  or 
immediate  inoculation." 

Haygarth   continued   thus  : — 

"  In  an  enquiry  how  to  prevent  the  Small  Pox,  it  is  a  point 
of  consequence  to  determine  Jioxv  long  the  variolous  poison  remains 
on  the  patient's  body.  I  have  collected  som.e  authentic  facts  on 
this  subject,  chiefly  from  the  register  of  the  Small  Pox  Society. 
Out  of  90  single  patients  the  shortest  continuance  of  the  poison 
was  to  the  tenth  and  the  longest  to  the  fortieth  day  from  the 
commencement  of  the  variolous  eruption  till  the  last  scab  dropt  off, 
and  of  these  only  16  were  later  than  the  thirty-eighth  day. 

Haygarth    then   pointed   out  that — 

"  All  the  discharges  of  a  Small  Pox  patient,  either  of  them- 
selves,  or  the  probable  mixture  of  serum,   pus,  or  scab  may  be 


BAVGARJH'S   SYSTJiAl.  85 

infectious,  and  ought  to  be  destroyed  by  cleanliness  in  order 
to  prevent  the  propagation  of  the  distemper.  .  .  .  That  '  persons 
liable  to  the  Small  Pox  are  infected  by  breathing  the  air  very 
near  the  variolous  poison  in  a  recent  state/  is  a  medical  opinion 
so  well  established  as  to  require  no  proof.  Let  us  reflect  how 
widely  and  fatally  this  poison  is  dispersed  among  all  ranks  of 
people.  It  may  be  conveyed  into  an}^  house  unobserved  from 
a  great  variety  of  families,  adhering  to  clothes,  food,  furniture, 
etc.,  as — 

"Clothes:  i,  Linen;  2,  Cotton;  3,  Woollen  (particularly 
flannel)  ;  4,  Silk  ;  5,  Millinery  goods  ;  6,  Stockings  ;  7,  Stays  ;  8, 
Gloves  ;  9,  Shoes. 

'^  Food :  10,  Bread;  11,  Cakes;  12,  Huxtery ;  13,  Fruit;  14, 
Butter;  15,  Milk;  16.  Sugar  and  other  groceries;  17,  Salt; 
18,  Tea;  19,  Nuts.  N.B. — Food  boiled  or  roasted  at  home  is 
probably  not  infectious. 

"'Furniture :  20,  Earthenware;  21,  Hardware;  22,  Dolls  and 
other  toys;  23,  Pens;  24,  Paper;  25,  Books;  26,  Letters;  27, 
Money  ;  28,  Medicines.  Tenfold  more  articles  might  be  enumer- 
ated ;  besides  several  of  these  I  have  mentioned,  as  linen,  etc., 
icludes  four  families  each,  who  by  this  means  may  communicate 
the  distemper,  namel}'  the  seller,  maker,  washer,  and  wearer.  .   .  . 

"The  clothes  of  a  patient  generally  contain  the  largest  quantity 
of  variolous  poison.  However,  all  the  enumerated  articles  and 
many  more  that  come  out  of  an  infectious  house  or  from  an 
infectious  person  find  their  way  unsuspected  into  all  families  of 
a  certain  rank.  The  poison  is  quickly  and  universally  dispersed 
among  the  lowest  class  of  people  whose  poverty  renders  them 
dirty." 

As  an  instance  of  the  long  time  that  the  variolous 
poison  retains  its  infectious  quality  in  clothes,  the 
following   example  was  quoted  : — ■ 

"  'About  17 1 8,  a  ship  from  the  East  Indies  arrived  at  the  Cape 
of  Good  Hope.  In  the  voyage,  three  children  had  been  sick  of 
the  Small  Pox  ;  the  foul  linen  about  them  was  put  into  a  trunk 


PREVENTION  OF  SMALL   POX. 


and  locked  up.  At  the  ship's  landing,  this  was  taken  out  and 
given  to  some  natives  to  be  washed.  Upon  handUng  the  Hnen, 
they  were  seized  with  the  Small  Pox,  which  spread  into  the 
country  for  many  miles,  and  made  such  a  desolation  that  it  was 
almost    depopulated.^ ' " 

Haygarth  added  : — 

"  From  a  variety  of  considerations  I  am  inclined  to  believe, 
that  the  most  usual  method  of  transferring  the  Small  Pox  to  a 
distant  place  is,  by  sending  to  relations  and  acquaintances  clothes, 
etc.,  bedaubed  with  the  variolous  poison;  either  shut  up  in  boxes, 
or  what  has  a  similar  effect,  folded  up  in  clothes,  paper,  etc.,  so 
as  to  exclude  all  access  of  fresh  air.  It  has  been  remarked  that 
relations  at  a  distance  are  infected  by  this  distemper  nearly  about 
the  same  time.  This  event,  I  believe,  happens  from  a  com- 
munication of  dirty  clothes,  etc.,  and  sometimes  possibly  from  a 
letter.  Whoever  reflects  that  a  piece  of  paper  on  which  a  letter 
is  written  may  have  lain  on  the  bed  where  there  is,  or  has  been, 
a  Small  Pox  patient,  or  on  a  table,  chair,  etc.,  where  the  foul  fi 
handkerchiefs,  clothes,  etc.,  are  thrown,  or  may  be  smeared  with 
variolous  matter  by  the  unwashed  hands  of  a  servant,  corre- 
spondent, or  a  patient ;  that  the  letter  is  folded  up  carefully  so  as 
to  exclude  the  air,  that  when  opened  it  is  held  near  the  mouth 
and  nose  to  be  read,  and  afterwards  a  child  puts  it  into  the 
mouth,  will  not  be  surprised  that  it  may  sometimes  communicate 
an   infection." 

Haygarth  argued  that  the  variolous  poison,  in  the 
form  of  serum,  pus,  and  scab,  by  impregnating  the  sur- 
rounding air,  was  the  sole  means  of  infection,  and  that 
if  this  were 'granted,  the  difficulty  of  prevention  would 
be  much  diminished.  A  number  of  cases  and  arguments 
were  ] produced,  to  show  that  the  air  is  only  rendered 
infectious  to  a  slight  distance   by  the  variolous  poison. 


'  Mead,  Or?  the  Plague. 


HAYGARTH' S  SYSTEM.  8; 


There  was  only  one  cause  that  would  be  likely  to 
disperse  the  infection  to  a  distance  from  the  patient's 
room,  viz.,  a  strong  wind  ;  provided  that  the  wind  blew 
directly  through  the  room,  an  uncommon  circumstance. 

"  To  diminish  the  force  of  this  argument,  it  may  be  suggested 
that  the  variolous  infection  is  a  ferment  which  by  an  admixture 
of  a  few  of  its  particles  with  blood  occasions  the  generation  of 
a  large  quantity  of  poison.  It  cannot  be  denied  that  by  inocula- 
tion a  very  small  portion  of  matter — and  we  may  even  allow  that 
by  natural  infection,  perhaps  a  much  smaller  quantity  of  miasms, 
dissolved  in  the  air  of  a  Small  Pox  chamber — -can  produce  in  some 
subjects  so  much  variolous  poison  as  would  communicate  the 
distemper  to  thousands ;  but  when  the  infectious  air  is  again 
diluted  several  hundred  times  with  fresh  air,  we  cannot  suppose 
it  to  retain  any  mischievous  energy.  A  fact  respecting  another 
kind  of  ferment  sets  this  point  in  a  true  light.  A  pint  of  yest 
is  sufficient  to  excite  a  fermentation  in  a  barrel  of  ale ;  but 
lOOth,  much  less  lOOOth  part  of  this  quantity  of  yest,  would 
not  have  the  effect." 

In  further  support  of  his  doctrine,  Haygarth  pointed 
out — 

"That  Small  Pox  was  epidemical  in  Chester,  from  May,  1777 
to  January   1 778.   .   .   . 

"(i)  At  the  beginning,  two  or  three  families  were  seized,  not 
immediate  neighbours,    but  in  the  same  quarter  of  the  town. 

"  (2)  Then  the  children  of  a  neighbourhood  comprehending  an 
entry  had  the  distemper,  but  it  did  not  spread  from  them  as  a 
centre. 

"(3^  In  no  part  of  the  town  it  has  spread  uniformly  from  a 
centre  farther  than  thro'  an  entry  or  narrow  lane,  where  all  the 
children  of  a  neighbourhood   play  together. 

"  (4)  Afterwards  the  poor  children  in  several  parts  of  the  towji 
were  attacked,  at  a  considerable  distance,  in  some  places  half 
a  mile  off  each  other, 

"(5)    Yet   many    portions    of  all    the    large    streets    were    not 


PREVENTION  OE  SJ\/ALL   FOX. 


infected  in  November ;  but  so  late  as  December  and  January  the 
distemper  returned  to  attack  many  who  had  escaped  when  it 
was  in   their   neighbourhood  some   months  before. 

"(6)  In  Handbridge,  a  part  of  Chester,  only  separated  from 
the  rest  of  the  town  by  the  river  Dee,  not  more  than  y  had 
been  infected  during  the  epidemic,  tho'  great  numbers  of 
children   in   this  quarter  are  liable   to   the  distemper. 

"  (7)  In  the  middle  of  the  city,  in  one  street  (King's)  of  24 
who  never  had  passed  thro'  the  distemper,  only  2,  both  in 
the  same  house,  were  attacked. 

"(8)  During  the  summer  and  autumn  of  1777,  while  this 
epidemic  was  general  in  Chester,  many  of  the  surrounding  villages 
(as  Christleton,  Barrow,  Tarven,  etc.),  and  some  larger  towns  (as 
Nantwich,  Neston,  etc.)  were  visited  by  the  Small  Pox  in  one 
or  more  families.  Yet  the  distemper  did  not  spread  generally 
thro'  any  of  these  towns.  As  both  the  state  of  the  air  and 
the  variolous  poison  were  the  same  in  these  places  as  in  Chester, 
why  did  it  not  equally  infect  their  air  as  well   as  ours  ? 

"  (9)  At  Frodsham  the  Small  Pox  began  in  May,  and  gradually 
became  more  frequent,  so  as  to  be  remarkably  epidemical  in  one 
part  for  several  months ;  yet,  nearly  one  half  of  the  town, 
Nov.  18,  1777,  still  remained  quite  uninfected.  On  the  con- 
trary, at  Upton,  a  small  village  2  miles  from  Chester,  of 
24  children,  who  had  never  been  attacked  by  the  distemper, 
all,  except  one  (who  was  also  certainly  exposed  to  the  in- 
fection), had  it  in  less  than  two  months.  The  reason  of  its 
speedy  propagation  I  shall  give  in  the  words  of  Mr.  Edwards, 
surgeon,   a  very  intelligent  inhabitant  of  the  place  : 

"  '  The  distemper  has  not  been  propagated  by  the  air  or  contiguity 
of  houses,  but  has  increased  in  proportion  to  the  communication  which 
families  have  with  each  other.  No  care  was  taken  to  prevent  the 
spreading ;  but,  on  the  contrary,  there  seemed  to  be  a  general  wish 
that  all  the  children  might  have  it.' 

"  (10)  It  is  universally  allowed  that  the  variolous  infection 
attacks  the  children  of  the  poor  people  first,  and  by  far  the  most 
generally ;  but  the  air  is  equally  breathed  both  by  rich  and  poor, 
and,  if  infectious,  would  equally  communicate  the  distemper  to  both 


HAYGARTH'S  SYSTEM. 


in  proportion  to  their  respective  numbers.  Many  instances  daily 
occur  of  a  favourite  child,  living  in  large  towns  where  the  Small 
Pox  almost  constantly  rages,  who,  by  anxious  care  to  avoid  the 
distemper,  has  escaped  it  till  arrived  at  maturity,  and  received 
the  infection  by  inoculation  or  by  mixing  with  society  in  a  less 
cautious  manner.  Of  many  gentlemen's  children  liable  to  the 
distemper  in  Chester,  not  one  was  seized  by  the  natural  Small 
Pox,  whose  infection  could  not  be  accounted  for,  during  the  whole 
time  of  this  epidemic."  .   .   . 

(ii)  A  gentleman's  famil}',  of  whom  eight  were  children  all 
liable  to  the  Small  Pox,  became  inhabitants  of  Chester,  and  on  the 
occasion  of  their  first  walk  in  the  town  they  met  a  child  a  year 
old  with  the  Small  Pox.  The  breadth  of  the  path  was  a  3'ard  and 
a  quarter.  One  of  the  children,  a  young  girl,  passed  within  half 
a  yard  of  the  child,  and  her  brothers,  she  believes,  were  all  as 
near.  Both  parties  walked  uniformly  forward  in  opposite  direc- 
tions, except  one  of  the  brothers,  who  out  of  curiosity  stopped  to 
look  at  this  Small  Pox  patient ;  he  did  not  touch  the  child,  but  he 
approached  nearer  than  any  of  the  others  of  the  party.  This 
brother  was  the  only  one  who  was  infected.  At  the  same  tim.e 
all  the  other  three  were  susceptible  of  Small  Pox,  for  they  were 
attacked  on  the  24th,  25th,  and  26th  day  after  they  met  the  child, 
being  infected  from  the  brother ;  while  another  brother  was  seized 
on  the  29th  November,  and  another  sister  on  December  the 
second,  who  had  not  accompanied  the  others. 

These  facts  afforded  an  opportunity  of  judging  how  small  a 
distance  in  the  open  air  a  Small  Pox  patient  exerts  a  pestilential 
influence.  The  following  account  indicated  that  the  variolous 
poison  in  a  house  is  not  infectious  to  any  persons  out  of  it.  Small 
Pox  occurred  in  a  family  in  a  quarter  of  the  town  where  there 
were  numbers  of  children  liable  to  infection.  The  new  method 
of  prevention  was  explained  to  a  lady  in  order  to  prevent  any 
of  her  neighbours  catching  the  disease.  "Tho'  two  of  her  children 
were  attacked  by  the  Small  Pox,  and  one  of  them  died,  yet, 
except  a  boy  who  had  been  in  the  sick  chamber  before  the  direc- 
tions were  given,  not  a  single  child  caught  the  disease,  altho' 
two  were  liable  to  it,  even  at  the  next  door,  and  not  fewer  than 
twenty  six  in  the  near  neighbourhood." 


90 


PREVENTION  OF  SMALL   POX. 


These  observations  convinced  Haygarth  that  Small 
Pox  did  not  render  the  surrounding  air  infectious  to  such 
a  distance,  as  to  frustrate  all  human  attempts  to  stop 
its  progress,  and  he  therefore  formulated  the  following 
conclusions  : — 

"If  the  Small  Pox  be  communicated  by  infection  and  by  infec- 
tion only  ;  if  it  be  only  caught  by  approaching  very  near  to  the 
variolous  poison  in  a  recent  state,  or  that  has  been  close  shut 
up  from  the  air  ever  since  it  was  recent ;  and  the  variolous 
miasms  do  not  render  clothes,  etc.,  infectious,  //  follows  that  the 
Small  Pox  may  be  prevented  by  keeping  persons  liable  to  the  distemper 
from  approaching  within  the  infectious  distance  of  the  variolous  poison 
till  it  can  be  destroyed.  The  variolous  poison,  if  exposed  to  the  air 
for  sufficient  time,  is  probably  deprived  of  its  infectious  quality, 
being  dissolved  in  the  atmosphere.  I  have  known  several  instances 
where  Small  Pox  was  communicated  in  the  open  air  by  two  persons 
meeting  and  walking  in  opposite  directions.  These  facts  proved 
that  an  infectious  quality  is  quickly  given  to  the  air,  and  consequently 
that  it  may  soon  be  exhausted.  .  .  .  The  epidemical  Small  Pox, 
which  has  been  attributed  to  a  peculiar  constitution  of  the  atmo- 
sphere by  the  sagacious  Sydenham,  and  by  most  other  physicians 
who  have  since  written  on  the  subject,  may  be  supposed  incom- 
patible with  this  conclusion  ;  but  1  think  it  can  be  explained  in  a 
satisfactory  manner  on  the  principles  of  this  inquiry."  .  .   . 

I  request  the  reader  to  consider  the  following  table  : — 

Deaths  by  the  Small  Pox  in   1781. 
Manchester.  \^ 


Januarj' 

3 

February 

5 

March 

10 

April 

17 

May 

3' 

June 

44 

July 

55 

August 

-        46 

September 

53 

October 

36 

November 

31 

December 

13 

ng 

ton. 

Chester 

7 

- 

- 

I 

8 

- 

- 

0 

5 

- 

- 

u 

5 

- 

- 

1 

5 

- 

- 

0 

b 

- 

- 

0 

3 

- 

- 

0 

4 

- 

- 

I 

3 

- 

- 

0 

0 

- 

- 

2 

2 

- 

- 

I 

2 

- 

- 

I 

344  50 


HAYGARTH'S   SYSTEM.  qi 


"  Hence  we  see,  on  surveying"  several  large  neighbouring  towns, 
as  Manchester,  Warrington,  and  Chester,  that  the  distemper  is 
very  seldom  absent  irom  any  of  them,  but  that  it  becomes 
generally  epidemical  at  uncertain  periods  in  each,  and  at  times 
which  hold  no  correspondence  with  one  another.  In  like  manner, 
on  comparing  several  neighbouring  villages,  we  observe  some 
entirely  free  from  the  distemper,  others  have  a  few  onl}-  infected, 
others  suffer  a  general  seizure.  .  .  .  Whoever  considers  the 
numerous  facts  here  faithfully  related  will  perhaps  be  convinced 
that  the  distemper  becomes  epidemical  neither  thro'  any  peculiar 
state  of  the  air,  nor  of  the  human  constitution.  No  such  difference 
can  reasonably  be  supposed  to  exist  in  large  towns  within  twenty 
miles  of  each  other,  much  less  in  neighbouring  villages,  and  least 
of  all  in  difterent  parts  of  the  same  town  or  village.  If  what 
is  above  advanced  be  true,  the  seeming  m3-ster3'  may  be  explained 
in  a  few  words.  The  Small  Pox  continues  spreading  as  long  as 
persons  liable  to  the  infection  approach  patients  in  the  distemper,  or 
infectious  matter,  either  in  the  same  chamber,  or  very  nearly  in  the 
open  air,  and  then  ceases.  The  next  point  was  to  inquire  in  what 
wa}'  this  theor}'  was  capable  of  practical  application,  '  either  by 
civil  regulations,  or  by  a  private  society  founded  on  principles 
of  charity  and  benevolence  to  mankind.'  With  this  end  in  view 
Ilaygarth  drew  up  the  following  instructions  : — 

"  Mankind  are  not  necessarily  subject  to  the  Small  Pox  ; 

IT  IS  ALWAYS  CAUGHT  BY  INFECTION  FROM  A  PATIENT  IN  THE  DIS- 
TEMPER, OR  THE  POISONOUS  MATTER,  OR  SCABS  THAT  COME  FROM 
A    PATIENT,    AND    MAY  ,  BE    AVOIDED    BY    OBSERVING    THESE 

"RULES  OF    PREVENTION. 

"I.  Suffer  no  person  who  has  not  had  the  Small  Pox  to  come 
into  the  infectious  house.  No  visitor  who  has  had  an}-  com- 
munication with  persons  liable  to  the  distemper,  should  touch  or 
sit  down  on  anything  infectious. 

"II.  No  patient,  after  the  pocks  have  appeared,  must  be  suffered 
to  go  into  the  street,  or  other  frequented  place. 

"III.  The  utmost  attention  to  clcanliiirss  is  absolutely  necessar}- 
during  and  after  the  distemper.  No  person,  clothes,  food,  furniture, 
dog,  cat,  money,    medicines,   or  any   other    thing    that   is  known 


92  PREVENTION  OF  SMALL  FOX. 

or  suspected  to  be  daubed  with  matter,  spittle,  or  other  infectious 
discharges  of  the  patient,  should  go  out  of  the  house  till  they 
be  washed,  and  till  they  have  been  sufficiently  exposed  to  the 
fresh  air.  No  foul  linen  or  anything  else  that  can  retain  the 
poison  should  be  folded  up  and  put  into  drawers,  boxes,  or  be 
otherwise  shut  up  from  the  air,  but  immediately  thrown  into 
water  and  kept  there  till  washed.  No  attendants  should  touch 
what  is  to  go  into  another  family  till  their  hands  are  washed. 
When  a  patient  dies  of  the  Small  Pox,  particular  care  should 
be  taken  that  nothing  infectious  should  be  taken  out  of  the  house, 
so  as  to  do  mischief. 

"  IV.  The  patient  must  not  be  allowed  to  approach  an}-  person 
liable  to  the  distemper  till  every  scab  is  dropt  off,  till  all  the 
clothes,  furniture,  food,  and  all  other  things  touched  by  the  patient 
during  the  distemper,  till  the  floor  of  the  sick  chamber,  and  till 
his  hair,  face,  and  hands  have  been  carefully  washed.  After 
everything  has  been  made  perfectly  clean,  the  doors,  windows, 
drawers,  boxes,  and  all  oi,her  places  that  can  retain  infectious 
air  should  be  kept  open  till  it  be  cleared  out  of  the  house." 

As  every  restriction  is  attended  with  inconvenience, 
Haygarth  proposed  that  a  rew^ard  should  be  given  for 
attention  to  the  rules,  and  this  w^as  to  be  secured  by 
annexing  to  them  a 

"promissory  note 

"  DATED 

"  The  Society  for  Promoting  General  Inoculation  at  stated  periods, 
and  for  Preventing  the  Natural  Small  Pox  /'//  Chester,  promises  to 

pay the  sum  of  [half-a-crown  or  a  crown,  or ] 

as  soon  as  all  the  scabs  have  dropt  off  the  patients  in 

family,  on  condition  that  the  said and family 

exactly  observe  the  foregoing  rules,  and  allow  any  member  of 
the  society,  or  their  nispector,  to  inquire  whether  they  are 
exactly  observed  :  and  as  a  farther  encouragement  to  follow  these 
directions  attentively  and  faithfully,  the  society  promise  [double  or 
]  the  reward  if  no  neighbour  or  acquaintance  be 


HAYGARTH'S  SYSTEM.  93 


attacked  by  the  Small  Pox  during  the  time  it  is  in  the  family  of 

the  said ,  nor  within  16  days  after  all  the  scabs   have 

entirely  fallen  ofif  the  family. 

"  By  order  of  the  Society, 

Inspector." 

As  there  were  inhabitants  to  whom  it  would  be 
improper  to  offer  pecuniary  reward,  it  was  thought 
desirable  to  affix  the  following  request  in  such  cases 
to  the  rules  : — 

"  The  independent  citizens  to  ivhoin  the  rewards  of  the  Society  will 
not  be  ivorth  acceptance,  are  earnestly  requested  to  observe  these 
regulations  through  motives  of  humanity,  in  order  to  preserve  their 
fellow  creatures  from  so  fatal  a  pestilence  as  the  natural  Small  Pox ; 
and  to  permit  the  inspector,  if  they  have  no  other  medical  visitor,  to 
see  that  they  are  observed,  lest  their  servants  inadvertently  spread  the 
contagiony 

An  inspector  was  to  be  appointed,  to  see  that  these 
rules  were  observed,  and  to  keep  a  register  containing 
full  information  of  families  attacked  with  the  Small 
Pox.  The  name,  address,  and  occupation  of  each 
patient  were  to  be  entered,  with  the  following  par- 
ticulars :  date  when  the  Small  Pox  fever  began,  date  of 
information,  date  of  receiving  the  rules  of  prevention, 
whence  infected,  date  of  death  or  last  scab,  date  of 
being  washed  and  aired,  whether  infection  was  com- 
municated or  not,  whether  the  rules  were  observed 
or  transgressed. 

It  was   also  considered  desirable    that,    where   it   was 
l)0ssible,  the  inspector  should  write  down  in  the  register 


94  PREVENTION  OF  SMALL  POX. 

the    proofs    of  infection.       Thus,    in   one  family   it   was 
necessary  to  move  into  another  house  while  they  were 
suffering  froni   Small    Pox.      One   of  the  children,   with 
the  eruption    upon    her,  ran    against  a   child    belonging 
to    another    family    who    probably    carried    home    some 
of  the    poison    upon    her    clothes.      Some  children    had 
been  allowed,  contrary  to  the  promise  of  the  parents,   to 
play   in   the   street,   and    they  communicated    the    Small 
Pox  to  another  family.       In    another    instance,    a    child 
with   the   eruption    upon   him    was    playing   in    a    street 
window  ;    he    cjave    a    teetotum     through    the     sash    to 
a   boy,   and  communicated  the    Small   Pox   to   a  family. 
Again,     bed-clothes    that     had     been     made     foul     by 
children   who  had   died   from  the   Small   Pox  were  sent 
to  a   distant  part   of  the   town   nearly  a  mile  off,  to   be 
washed,    and   communicated    the    distemper    to   another 
family.       Hay  garth    anticipated    that    experience    would 
discover   defects    in  the   regulations,   but   it  was  reason- 
ably hoped  that   such    defects   would   admit    of  a   prac- 
tical   correction.      Haygarth    also    stated    that    he   could 
deduce    many    facts    from    other    infectious    distempers 
in   favour    of  the    doctrine    maintained    in   the    inquiry  ; 
but  he   considered    that    argument   from    analogy  would 
be   superfluous    after    so    many   direct  proofs   had    been 
produced. 

As  the  result  of  these  sanitary  measures,  we  find 
that  in  a  rejjort  by  the  inspector,  it  was  certified  that 
the    Small    Pox  had  been  stopped  in  ten   different  parts 


HAY  GARTH'S  SYSTEM.  95 


of  the  city,  and  that  so  tar  as  could  be  learned  from 
minute  inquiries,  there  were  only  three  Small  Pox 
patients  in  Chester,  results  which  were  principally 
produced  by  the  rules  and  the  rewards  of  the  Society 
for  preventing  the   Small    Pox. 

When  in  1778,  Haygarth  submitted  the  preceding 
inquiry  to  the  consideration  of  his  friends,  including 
Dr.  Waterhouse,  he  ascertained  that  this  practice  had 
actually  been  carried  out  for  a  long  series  of  years 
in  Rhode  Island.  In  Boston  and  Rhode  Island, 
inoculation  was  discouraged,  and  the  following  method 
was  employed  for  preventing  the  Small   Pox  : — 

If  any  who  resided  in  those  parts  had  gone  to  the 
Southern  Provinces  to  be  inoculated  they  were  enjoined 

"never  to  bring  back  any  of  their  clothes  worn  during  their 
stay  at  the  inoculating  place.  Never  to  quit  it  till  a  certain  space 
of  time — fixed  by  the  inoculators — be  the  disease  ever  so  slight. 
And  if  they  have  any  sores  about  them  when  they  arrive  in  the 
harbour,  not  to  come  on  shore  till  they  are  examined  by  the 
inspector  appointed  for  that  purpose." 

If  a  case  of  Small  Pox  occurred  in  the  town  the 
inspector  was  sent  for  ;  if,  in  his  opinion,  the  person 
were  infected,  he  took  with  him  some  overseers  of  the 
Small  Pox,  and  if  they — in  conjunction  with  a  prac- 
titioner— pronounced  it  to  be  a  case  of  the  Small  Pox, 
the  family  had  little  more  to  do  with  the  patient,  who 
was,  from  that  time  to  the  conclusion  of  the  disease, 
wholly  under  the  direction  of  these  officers,  who  removed 


96  PREVENTION  OF  SMALL   POX. 

him    to    an    island    where     everything     convenient    was 
already  provided. 

If  the  disease  were  so  far  advanced  before  it  was 
known  to  be  the  Small  Pox,  that  the  patient  could  not 
be  removed  without  danger,  the  street  was  boarded 
up,  the  fact  was  advertised  in  the  newspaper,  and 
guards  were  placed  to  prevent  any  person  coming  to 
within  a  certain  distance  of  the  house.  If  a  vessel 
arrived  in  the  harbour  with  Small  Pox  on  board,  the 
sick  were  taken  to  the  island  before  referred  to,  the 
ship  was  obliged  to  undergo  quarantine  and  to  hoist 
a  jack  in  her  shrouds,  in  which  case  no  boats  could 
board  her.      Dr.   Waterhouse  adds  : — 

"  I  acknowledge  some  of  these  rules  are  unnecessary  and  in- 
convenient, but  the  dread  of  this  disorder  induces  the  people  to 
adhere  to  them  with  cheerfulness.  A  stranger  would  be  ready  to 
conclude  that  they  could  not  be  so  scrupulous^  complied  with, 
without  exerting  an  authority  disagreeable  to  the  people ;  but  it  is 
not  the  case,  for  the  united  voice  of  the  people  coinciding  with 
the  magistrate,  gives  every  regulation  its  wished  for  effect  ;  so  that 
it  rather  appears  like  a  popular  custom  than  the  restraints  of  the 
law." 

Haygarth  proposed  to  have  general  inoculation  at 
stated  intervals,  but  it  was  only  at  such  time  as 
would  be  most  agreeable  to  the  inhabitants  in  general. 
The  object  of  having  a  general  inoculation  was,  of 
course,  to  avoid  the  danger  of  propagating  the  in- 
fection ;  because,  if  the  inoculation  were  general,  no 
subject  liable  to   infection    would    remain.      It  was   only 


HAYGARTH'S  SYSTEM. 


97 


proposed  to  perform  this  at  a  fixed  time  once  in 
about  two  years,  or  less  fi-equently,  and  this  was  to 
be  publicly  made  known,  so  that  those  who  never 
had  the  disease  might  easily  avoid  all  intercourse  with 
the  infectious.  The  practice  of  inoculation  was  to  be 
altogether  subsidiary  to  the  plan  of  stamping  out  the 
disease  by  isolation,  the  latter  system  however  was 
regarded  by  many  as  visionary,  it  was  not  generally 
adopted,  and  when  the  promise  of  perfect  and  ever- 
lasting security  was  made  by  the  promoters  of  Cow 
Pox  inoculation,  Haygarth's  system  was  ignored  and 
lost   sight   of. 


VOL.  T 


CHAPTER  V. 

THE    TRADITIONS    OF   THE   DAIRYMAIDS. 

Adams  in  his  work  on  Morbid  Poisons  writes  : 
"  Shall  we  forget  that  to  the  barbers  we  owe  the 
bold  use  of  mercury,  to  the  Jesuits,  of  the  Peruvian 
bark,  which  they  learned  of  the  Indians,  that  an 
African  showed  us  the  value  of  quassia,  that  a  Greek 
slave  tauQfht  a  woman  the  art  of  inoculation,'  the 
blessings  of  which  were  for  a  time  almost  lost  by  our 
fancied  improvements  and  ill-directed  cautions  ?  Lastly, 
shall  we  contrast  all  this  with  the  manner  in  which  a 
Jenner  has  availed  himself  of  the  neglected  traditions 
of  cowherds  and  dairymaids  ?  " 

In  some  parts  of  the  country,  a  belief  existed  among 
those  who  had  the  care  of  cattle,  that  a  disease  of 
cows,  which  they  called  Cow  Pox,  when  communi- 
cated to  the  milkers,  afforded  them  protection  from 
Small   Pox. 

It  is  not  without  importance  to  consider  when,  and 
how,  this  belief  arose.  Pearson  and  Jenner  were  both 
of  opinion   that    it    originated    simultaneously    with    the 


TRADITIOyS  OF  THE  DAIRYMAIDS.  99 

introduction  of  Small  Pox  inoculation.  It  remains  to 
be  seen  how  far  their  conclusion  will  enable  us  to  explain 
the   origin  of  this  tradition   of  the  dairymaids. 

Had  a  belief  in  the  protective  power  of  Cow  Pox 
existed  prior  to  the  practice  of  inoculation,  the  early- 
writers  on  Sniall  Pox  would  doubtless  have  mentioned 
it,  and  possibly  explained  it  as  the  outcome  of  the 
experience  of  persons  who  had  contracted  Cow  Pox 
and  had  not  subsequently  caught  Small  Pox.  But, 
although  Cow  Pox  and  natural  Small  Pox  have  been 
known  from  time  immemorial,  there  is  no  evidence  to 
show  that  this  belief  originated  simultaneously  with 
the  early  experience  of  these  diseases.  How  was  it, 
we  may  ask,  that  the  tradition  arose  as  a  result  of 
Small  Pox  inocidation  ?  It  was  evidently  failure  in 
attempting  to  inoculate  Small  Pox  on  the  arms  of 
those  who  had  recently  contracted  Cow  Pox,  which 
gave  rise  to  gossip  among  the  dairymaids,  and  laid 
the  foundation  of  the  popular  tradition.  The  dairy- 
folk  could  not  be  expected  to  distinguish  between 
inoculated  Small  Pox  and  Small  Pox  caught  in 
the  natural  way,  and  the  fact  that  some  Cow 
Poxed  milkers  were  proof  against  inoculation  was  so 
interpreted,  as  to  afford  a  foundation  for  the  popular 
belief  that  they  were  for  ever  after  secured  trom  the 
danger  of  catching  the  Small  Pox.  In  many  parts 
of  the  country,  the  tradition  was  unknown  amongst 
those    who    were    quite    familiar    with    Cow    Pox  ;    and 


cow  POX  AND   SMALL  FOX. 


this  may  be  explained  by  the  fact  that  inoculation 
of  Small  Pox  was  much  more  commonly  practised 
in  some  counties  than  in  others.  Another  circumstance 
which  points  to  the  relation  between  this  tradition  and 
the  inoculation  of  Small  Pox,  is,  that  the  resistance  in 
some  cases  of  those  who  had  had  Cow  Pox  w^as  known 
to  those  who  practised  inoculation  in  the  country,  long 
before  it  was  brought  to  the  notice  of  the  profession 
generally.  Thus,  it  was  alleged  that  the  following 
statements  were  found  among  the  papers  of  Mr.  Nash^ 
after  his    death  : — 

"  It  is  rather  remarkable  that  no  writer  should  have  taken 
notice  of  the  Cow  Pox. 

"  I  never  heard  of  one  having  the  Small  Pox  who  ever 
had  the  Cow  Pox.  The  Cow  Pox  certainly  prevents  a  person 
from  having  the  Small  Pox.  I  have  now  inoculated  about 
sixty  persons  who  have  been  reported  to  have  had  the  Cow 
Pox,  and  I  believe  at  least  forty  of  them  I  could  not  infect 
with  the  variolous  virus ;  the  other  twenty,  or  nearly  that 
number,  I  think  it  very  reasonable  to  presume  (as  they  were 
no  judges),  had  not  the  real  Cow  Pox.  It  is  not  my  own 
opinion  only,  but  that  of  several  other  medical  gentlemen, 
that  convinces  me  the  Cow  Pox  is  a  prophylactick  for  the 
Small   Pox. 

"  I  have  not  been  able  to  discover  that  the  human  species 
get  it  from  the  cows  in  any  other  manner  than  by  contact 
with  the  parts  immediately  infected,  such  as  in  milking ;  neither 
do  1  apprehend  that  one  of  the  human  species  can  communicate 
it  to  another  but  by  the  same  means,  as  I  have  known  some 
of  the  inhabitants  of  a  house  where  it  was  escaped,  but  none 
of  those  who  lay  in  the  same  bed  with  the  diseased  person. 

'  Pearson.  A?i  Examinafioii  of  the  Report  of  the  Committee  of  the 
I/o7/s('  of  Connnons,  1802,  p.  24. 


TRADITION'S   OF  THE  DAIRYAIAIDS.  loi 

"  /;/  Mrs.  Scammell  and  Mrs.  Bracher,  inoculation  produced 
no  eruption,  no  sickness,  and  little  or  no  suppuration  of  the  arm, 
the  place  punctured  not  being  bigger  when  inflamed  and 
suppurated  than  a  large  pin's  head.  It  frequently  leaves 
considerable  marks,  which  are  much  larger  than  those  of  the 
Small  Pox,  as  large  (I  have  measured  some)  as  a  silver 
threepence. 

"  My  principal  intention  in  publishing  being  to  recommend 
tT  the  world  a  method  of  inoculation  that  is  far  superior,  in  my 
opinion  (and  I  judge  it  from  experience),  to  any  yet  made 
known,  therefore  I  hope  and  trust,  although  I  have  no 
medical  friend  to  enforce  it  upon  the  world,  that  they  will 
give  me  so  far  credit  for  my  assertions  as  to  make  the 
experiment,  and  then  it  will  sufficiently  introduce  itself.  But 
if,  from  my  being  so  little  known,  they  should  disregard  it,  I  can- 
not but  remind  them  that  we  had  the  art  of  inoculation  first 
from  Grecian  women,  who  were  both  ignorant  and  illiterate, 
and  put  them  in  remembrance  of  the  saying  of  Hippocrates, 
Mt;  oKveeiv,  etc.  Upon  looking  into  the  systematic  writers,  as 
Sauvages  and  Machide,  or  those  who  have  made  catalogues 
of  definitions  of  disease,  as  Linnaeus,  Vogel,  and  CuUen,  I  do  not 
find  any  disease  mentioned  by  them  at  all  like  the   Cow  Pox. 

"  Although  some  people  cannot,  from  the  peculiar  nature  of 
their  constitutions,  take  the  Small  Pox ;  but  that  cannot  be  the 
reason  of  so  many  persons  in  one  part  of  the  country,  and  no 
other,   being  incapable    of   taking   the  Small  Pox. 

"  That  it  is  not  more  surprizing  that  no  one  has  written  on 
the  Cow  Pox,  since  Dr.  Heberden  was  the  first  who  described 
the  Chicken  Pox,  which  had  been  in  the  country  one  hundred 
years. 

"When  those  who  have  had  the  Cow  Pox  are  inoculated, 
the  arms  inflame,  but  never,  or  at  least  seldom,  form  an 
abscess,   but  some  hard  tumour  in  the  muscular  flesh. 

"  On  cows,  the  Cow  Pox  usuall}'  appears  at  first  in  round 
pustules,  afterwards  in  ulcers  upon  the  teats  and  udders,  but 
principally  upon  the  teats.  They  do  not  appear  to  have  any 
sickness  before  it  comes  out.  Their  teats  are  so  far  injured  by  the 
inflammation  it  produces,  that  people  are  frequently  obliged  to  open 


COl^F  POX  AND   SMALL  POX. 


the  tubes  through  which  the  milk  passes  with  a  knitting  needle 
or  some  such  instrument.  One  cow  having  it  will  communicate 
it  to  a  whole  dairy.  It  continues  after  a  long  time  upon  them 
unless  proper  '  means '  be  employed  to  cure  them,  which  means 
are  the  unguents  to  the  sore  parts.  The  best,  I  am  told,  is  soot 
and  butter.     This  disease  is  not  very  frequent  in  this  country. 

"  Cows  have  the  disease  but  once. 

"  I  have  not  yet  been  able  to  determine  whether  a  person 
who  has  had  the  Small  Pox  can  receive  this  disease. 

"  In  those  who  have  had  the  Cow  Pox,  the  arm  on  inoculation 
for  Small  Pox  is  inflamed  to  a  greater  extent  than  in  those 
who  have  not  had  it  ;  but  then  there  is  little  or  no  matter  in 
the  middle,  where  the  puncture  was  made,  nor  does  it  fill  as  in 
those  who  have  not  had  this  disease,  but  soon  heals  and  dries." 

Mr.  Nash's  observations  were  written  in  the  year 
1 78 1,  and  he  died  in  1785.  The  papers,  on  his 
death,  were  sent  by  his  mother  to  her  brother,  Mr. 
Battiscombe.  They  passed,  about  1795,  to  Mr.  Thomas 
Nash,  and  from  him,  in  1799,  to  Mr.  Robert  Keate.  It 
was  rumoured  that  Jenner   was  acquainted   with    Nash. 

Similar  testimony  was  afforded  by  Mr.  Rolph,^  who 
had  practised  for  nine  years  in  Gloucestershire,  and 
was  well  acquainted  with  Cow  Pox,  and  had  experi- 
enced many  failures  to  inoculate  milkers  who  had 
contracted  this  disease.  Mr.  Rolph  for  two  years  was 
a  partner  of  Mr.  Grove,  who  had  been  a  medical 
practitioner  at  Thornbury  for  nearly  forty  years, 
and     the   following    facts     related    by    Mr.    Rolph    were 

from  his  own  observations  and  the  experience  of 
Mr.  Grove : — 

'   Pearson,  loc.  cit.^  p.  13. 


TRADITIONS   OF  THE  DAIRYMAIDS.  '    103 

"  Cow  Pox  is  very  frequently  epizootic  in  the  dairy-farms  in 
the  spring  season.  It  especially  breaks  out  in  Cows  newly  intro- 
duced into  the  herds.  When  a  number  of  Cows  on  a  farm  are  at 
the  same  time  affected,  the  infection  seems  generally  to  have 
originated  in  the  constitution  of  some  one  Cow,  and  before  the 
milker  is  aware  of  the  existence  of  the  disease,  the  infectious 
matter  is  probably  conveyed  by  the  hands  to  the  teats  and  udders 
of  other  Cows.  Hence  they  are  infected.  For  if  the  disease  in  the 
Cow  first  affected  be  perceived  in  a  certain  state,  and  obvious 
precautions  be  taken,  the  infection  does  not  spread,  but  is  confined 
to  a  single  beast.  Whether  the  morbific  poison  is  generated  in 
the  Cow  first  diseased  in  a  farm,  de  novo,  from  time  to  time,  and 
disseminated  among  the  rest  of  the  herd,  or,  like  the  Small  Pox 
poison,  is  only  communicated  from  animals  of  the  same  species  to 
one  another,  is  not  ascertained.  No  cow  has  been  knovv'n  to  die, 
or  to  be  in  danger  from  this  disorder." 

Numbers  of  cases  of  milkers  suffering  from  Cow 
Pox  had  fallen  under  Mr.  Rolph's  observation,  and 
many  hundreds  more  under  that  of  his  late  partner, 
Mr.  Grove ;  but  not  a  single  fatal  or  even  dangerous 
case  had  occurred.  The  patients  ordinarily  were  ill 
of  a  slight  fever  for  two  or  three  days,  and  the  local 
affection  seldom  called  for  the  assistance  of  a  medical 
practitioner. 

Mr.   Rolph  added  : — 

"There  is  not  a  medical  practitioner  of  even  little  experience 
in  Gloucestershire,  or  scarce  a  dairy  farmer,  who  does  not  know, 
from  his  own  experience  or  that  of  others,  that  persons  who  have 
suffered  the  Cow  Pox  are  exempted  from  the  agency  of  the 
variolous  poison. 

"  The  late  Mr.  Grove  was  a  very  extensive  Small  Pox  inocu- 
lator,  frequently  having  two  hundred  to  three  hundred  patients 
at  one  time,   and  the  fact  of  exemption,  now  asserted,  had  been 


104  COJV  POX  AND   SMALL   POX. 

long  before  his  death  abundantly  established,  by  his  experience  of 
many  scores  of  subjects,  who  had  previously  laboured  under  the 
Cow  Pox,  being  found  unsusceptible  of  the  Small  Pox  either  by 
inoculation  or  by  effluvia." 

Mr.  Rolph  estimated  that  while  he  practised  at 
Thornbury,  not  less  than  threescore  instances  of  failure 
in  attempting  to  produce  the  Small  Pox  by  inoculation 
occurred  in  his  own  practice,  and  all  these  were  cases 
of  persons  who  had  been  previously  affected  with  the 
Cow  Pox  ;  almost  all  freely  associated  with  those  who 
took  Small  Pox,  and  many  were  repeatedly  inoculated, 
without  being  infected.  Mr.  Rolph  was  not  able  to 
recollect  any  instances  of  persons  taking  the  Small 
Pox  after  the  Cow  Pox,  but  he  was  of  opinion  that 
cases  may  have,  and  indeed  had,  occurred  to  others. 

Mr.  Dolling,  a  practitioner  at  Blandford,  had  inocu- 
lated a  number  of  persons  who  said  they  had  had 
Cow    Pox,   and  very  few  of  them  took    the   infection. 

Mr.  Fewster,  who  in  his  early  days  was  associated 
with  Sutton  in  the  practice  of  inoculation  for  Small 
Pox,  had  repeatedly  heard  the  tradition  that  Cow  Pox 
afforded  security  against  Small  Pox,  and  had  met  with 
cases  in  his  own  practice  which  seemed  to  support  the 
tradition. 

About  seventeen  years  before  the  publication  of 
Jenner's  Inquiry,  a  woman  who  had  had  Cow  Pox 
went  to  an  Inoculation  Hospital  to  ascertain  whether 
there  was  any  truth  in  the  common  belief,  in  order 
to    satisfy    her    brother's    curiosity.      This    circumstance 


TRADITIONS  OF  THE  DAIRYMAIDS.  105 

is  thus  related  b)"  Dr.  Lettsom  in  his  Observations  on 
tJie  Coio  Pock,  pubHshed  in  1801,  just  three  years 
after  the  publication  of  Jenner's   Inquiry. 

"Although  the  Cow  Pock  has  long  since  been  found  by  in- 
cidental experience  a  security  against  the  Small  Pox,  it  had  never 
been  applied  to  any  beneficial  purpose  till  the  genius  of  Jenner 
discriminated  its  powers,  and  introduced  it  into  practice  as  a 
permanent  security  against  the  variolous  infection.  This  pre- 
ventive quality  of  the  vaccine  fluid  was  certainly  known  even  to 
scientific  professional  men  many  years  ago;  but,  strange  as  it  may 
now  appear,  no  one,  till  Jenner  promulgated  his  discovery,  had 
ever  improved  that  knowledge  by  applying  it  to  the  process  of 
inoculation.  About  twenty  years  ago,  when  Dr.  Archer  was  the 
physician  of  the  hospital  for  inoculation,  Catherine  Wilkins,  now 
Titchenor,  from  Cricklade  in  Wiltshire,  who  had  had  the  Cow 
Pock  in  consequence  of  milking  cows,  came  to  her  brother  in 
London  (where  she  is  now  resident),  who,  being  desirous  of 
ascertaining  whether  this  circumstance  could  be  depended  upon 
as  preventive  of  the  Small  Pox,  sent  her  to  the  hospital  for  inocu- 
lation, when  she  received  the  variolous  matter  from  Dr.  Archer, 
against  which,  however,  she  was  proof,  and  the  Small  Pox,  of 
course,  could  not  be  communicated  ;  but  no  advantage  was  derived 
from  the  fact." 

Not  only  was  the  tradition  well  known  to  Inocu- 
lators,  but  we  are  also  informed  that  there  were  many 
who  did  not  believe  it  ;  for  it  was  equally  well  known 
that  many  who  had  contracted  Cow  Pox  had  sub- 
sequently suffered  from  Small  Pox.  It  was  owing  to 
this  that  when  Jenner  mentioned  to  his  professional 
neighbours  the  subject  of  the  prophylactic  power  of 
Cow  Pox,  their  reply  was  not  very  encouraging/ 


•  Baron.     Life  0/ £.dward 'Je7i?ier,  \o\.i.,  "p.  125. 


io6  COW  POX  AND   SMALL  POX. 

"  We  have  all  heard "  (they  would  observe)  "  of  what  you 
mention,  and  we  have  even  seen  examples  which  certainly  do 
give  some  sort  of  countenance  to  the  notion  to  which  you  allude  ; 
but  we  have  also  known  cases  of  a  perfectly  different  nature, — 
many  who  were  reported  to  have  had  the  Cow  Pox  having  sub- 
sequently caught  the  Small  Pox.  The  supposed  prophylactic 
powers  probably,  therefore,  depend  upon  some  peculiarity  in  the 
constitution  of  the  individual  who  has  escaped  the  Small  Pox,  and 
not  on  any  efficacy  of  that  disorder  which  they  may  have  received 
from  the  cow.  In  short,  the  evidence  is  altogether  so  inconclusive 
and  unsatisfactory  that  we  put  no  value  on  it,  and  cannot  think 
that  it  wiil  lead  to  anything  but  uncertainty  and  disappointment." 

In  Dorsetshire,  according  to  Mr.  Dow^ne,^  a  similar 
disbelief  prevailed  among  the  public  as  well  as  among 
some  of  the  practitioners  in  those  parts. 

"  The  lower  class  of  people  still  refuse  the  vaccine  inoculation, 
from  an  opinion  that  the  resistance  to  the  Small  Pox  after  it,  will 
wear  out  in  a  few  years,  which  opinion  some  medical  practitioners 
encourage." 

The  tradition  was  founded  on  the  fact  that  an  attack 
of  Cow  Pox  interfered  with  inoculated  Small  Pox,  and 
it  is  not  therefore  surprising  that  it  should  have  been 
generally  accepted  by  the  country  people  as  worthy 
of  credit,  and  that  attempts  should  have  been  made  to 
communicate  the  disease  by  different  methods,  with  a 
view  to  afford  the  benefits  that  were  alleged  to  result, 
when  the  disease  was  contracted  by  the  milkers.  Two 
methods  would  naturally  suggest  themselves  to  the 
peasant  mind  :  either,  to  handle  the  teats  of  the  cows, 

'  Letter  from  Mr.  N.  S.  Downe,  Surgeon,  dated  Bridport,  June  7,  1802, 
to  Dr.  Pearson. 


TRADITIONS   OF  THE  DAIRYMAIDS.  107 

or  to  inoculate  themselves  in  the  arm  with  a  needle, 
according  to  the  method  commonly  employed  in 
some  parts  of  the  country  in  the  practice  of  buyincr 
the  Small   Pox. 

Dr.  Pulteney  ^  had  heard  of  an  instance  in 
which  Cow  Pox  had  been  contracted  intentionally  by 
contact. 

'*A  very  respectable  practitioner  informtd  me  that  of  seven 
children  whom  he  had  inoculated  for  the  Small  Pox,  five  had  been 
previously  infected  with  the  Cow  Pox  purposely,  by  being  made  to 
handle  the  teats  and  udders  of  infected  Cows ;  in  consequence  of 
which  they  suffered  the  distemper.  These  five,  after  inoculation  for 
the  Small  Pox,  did  net  sicken  ;  the  other  two  took  the  distemper." 

Mr.  Downe  gave  the  following  history  of  intentional 
inoculation   in  the  year   1771  : — 

"  Robert  Fooks,  a  butcher  near  Bridpcrt,  31  years  ago, 
when  about  20  years  of  age  was  at  a  farmhouse  when  the  dairy 
was  infected  with  the  Cow  Pox.  It  being  suggested  to  him  that  it 
would  be  the  means  of  preserving  him  from  the  Small  Pox,  which 
he  had  never  taken,  if  he  would  submit  to  be  inoculated  with  the 
Cow  Pox  matter,  he  gave  his  consent  :  he  was  infected  by  a  needle 
in  two  or  three  places  in  his  hand.  In  about  a  week,  the  parts 
began  to  inflame  and  his  hand  to  swell,  his  head  to  ach,  and  many 
other  symptoms  of  fever  came  on.  The  parts  inoculated  left 
permanent  scars.  He  was  afterwards  inoculated  twice  by  my 
grandfather,  and  a  considerable  time  after,  twice  by  m}'  father, 
but  without  any  effect  than  a  slight  irritation  of  the  part,  such  as 
is  occasioned  in  the  arms  of  persons  who  have  already  had  the 
Small  Pox.      The  Small   Pox  has  been  repeatedly  since  in  his  own 

'Letter  from  Dr.  Pulteney  to   Dr.   Pearson,   dated  Blandford,  July   14, 
i:q8. 


cow  FOX  AND   SMALL  POX. 


family,  and  he  never  avoided  it,  being  confident  that  it  was  not 
possible  to  infect  him  with  this  disease." 

Mr.  Nicholas  Bragge,^  an  apothecary,  reported  In  a 
letter  written  in  1802,  that  a  farmer's  w^ife  had  performed 
a  similar  operation. 

"  It  is  now,  I  believe,  twenty  years  ago  that  Mrs.  Kendall,  the 
wife  of  a  respectable  farmer  in  the  parish  of  Whitechurch,  near 
Lyme,  in  Dorsetshire  (who  is  at  this  time  a  tenant  to  Lady 
Caroline  Damer,  in  the  same  parish  for  which  I  have  been  con- 
cerned as  an  apothecary  for  the  poor  ever  since  I  have  been  in 
business),  inoculated  herself  and  three  or  four  children  for  it ; 
and  those  children,  who  have  long  arrived  at  manhood,  have  since 
inoculated  their  friends  and  neighbours  whenever  an  opportunity  has 
offered." 

But  these  inoculations  were  not  only  performed  by 
farmers'  wives.  Mr.  Nicholas  Bragge  appears  himself 
to  have  inoculated  Cow  Pox,  and  to  have  advocated 
its  prophylactic  efficacy. 

"  It  is  now  more  than  thirty  years  ago  that  I  first  made  ex- 
periments, and  proved  that  the  Vaccine  Distemper  was  a  preser- 
vative against  the  Small  Pox  ;  and  it  is,  I  believe,  more  than 
twenty  years  ago,  that,  through  the  Rev.  Herman  Drew,  I 
acquainted  Sir  George  Baker  with  the  observations  and  experi- 
ments I  had  then  made,  which  I  am  certain  Sir  George  will 
readily  acknowledge." 

This  statenient  was  supported  by  Mr.  Tucker,^  in 
a  letter   in    1802,   in   which   he  wrote  that  Mr.   Bragge, 

'  Mr.  Nicholas  Bragge's  Letter,  dated  Axminster,  April  12,  1802,  to 
Sir  William  Elford,  Bart. 

-Letter  from  William  Tucker,  Esq.,  of  Coryton,  in  Devonshire,  to  Sir 
William  Elford,  Bart.,  April  J2,  1802. 


TRADITIONS   OF  THE  DAIRYMAJDS.  109 

twenty  years  ago,  with  great  assiduity  recommended 
the  practice  of  vaccine  inoculation,  and  had  furnished 
Sir  George  Baker,  through  the  Rev.  Herman  Drew, 
with  a  variety  of  papers  in  proof  of  its  being  a  sure 
guard    against    Small    Pox. 

The  Rev.  Herman  Drew  ^  was  not  only  interested  in 
Mr.  Bragge's  researches,  but  in  a  letter  conveys  the 
impression  that  he  too  had  performed  some  experiments 
about   1782. 

•*  Nearly  twenty  years  ago,  I  wrote  sheets  of  paper  to  Sir 
George  Baker  on  this  disorder,  and  I  know  not  what  occasioned 
his  laying  aside  his  intention  of  publishing  his  investigations. 
He  had  had  a  previous  correspondence  with  Dr.  Pulteney  of 
Blandford  on  the  subject.   .   .  . 

"  No  one  can  have  an  higher  opinion  of  the  good  effects  of  the 
vaccine  inoculation  than  I  have.  It  has  occupied  my  thoughts 
for  years,  and  nothing  but  Horace's  advice,  '  Ne  sutor  ultra 
crepidam,'  has  checked  me  from  the  use  of  the  infected  lancet 
or  saturated  cotton.  E litre  nous,  I  have  had  a  little  sitccessjnl 
practice." 

According  to  Dr.  Barry,  the  casual  Cow  Pox  (or 
Shinach)  had  been  known  in  Ireland,  perhaps,  as  long 
as  the  Small  Pox.  Instances  had  occurred  of  persons 
having  had  the  Cow  Pox  about  1 750,  and  one 
woman,  eighty  years  of  age,  asserted  that  as  long 
as  she  could  remember,  the  opinion  prevailed  that 
people    ivho   had  the   Coiu   Pox    cannot   take    the    Small 


'  Letter    from  the   Rev.    Herman    Drew  to    Sir  William    Klford,   Bart., 
l.ited  Abbots,  near  Honiton,  April  i,  1802. 


corr  FOX  and  small  pox. 


Pox;    and    that    people    purposely    exposed    themselves 
to  it  to  protect  themselves  from  the   Small   Pox. 

Two  cases  of  intentional  inoculation  in  Ireland  were 
related  by   Dr.    Barry. ^ 

"A  woman  ill  of  the  casual  Cow  Pox,  by  handling  her 
infant  then  at  her  breast,  produced  Cow  Pox.  Two  years  after 
this  child  slept  with  another  child  with  Small  Pox,  and  was 
also  inoculated  for  Small  Pox,  but  without  exciting  the  disease." 

"  A  gardener  gave  himself  the  Cow  Pox  purposely  by  rubbing 
himself  against  some  person  who  was  affected  with  it,  from 
a  conviction  that  it  would  prevent  the  Small  Pox.  This 
happened  several  years  ago  ;  and  though  he  has  often  put  him- 
self in  the  way  of  Small  Pox  infection,  and  even  lain  in  the 
same  bed  with  his  children  when  they  were  covered  with  it, 
he  has  not  taken  the  disease.  If  I  had  time  to  make  the 
necessary  inquiries  I  am  sure  I  could  multiply  instances  of 
this  kind." 

Mr.  Jesty. — It  may  perhaps  be  said,  that  there 
is  very  little  interest  in  the  accounts  which  have 
just  been  related,  owing  to  the  absence  of  sufficiently 
reliable  evidence,  to  entitle  them  to  be  regarded  as 
authentic.  But  this  cannot  be  said  of  the  inoculations 
performed  by  Mr.  Jesty.  I  shall  give  in  full  all  the 
evidence  which  I  have  been  able  to  collect  from 
different  sources,  with  a  view  of  establishing  Jesty's 
experiment  as  an  historical  fact,  for  Jenner  regarded 
the  account  of  it  as  an  invention  to  deprive  him  of 
the  merit  of  discovering  Cow  Pox  inoculation.  Baron, 
the  biographer  of  Jenner,  turned  a  deaf  ear  to  anything 

'  Letter  to   Dr.    Pearson,  Oct.   i6,    1800,    and  Medical  and  Physical 
Journal,  p.  503.      1800. 


TRADITIONS   OF  THE  DAIRYMAIDS. 


which  he  considered  might  detract  from  Jenner's  credit, 
and  only  referred  in  his  biography  to  Jesty's  alleged 
vaccinations  ;  and  in  more  recent  times  in  Simon's 
history  of  vaccination  there  is  no  mention  of  Jesty 
whatever. 

Benjamin  Jesty  held,  at  one  time,  a  large  farm  at 
Yetminster  in  Dorset,  and  carried  on  an  extensive 
business  by  sending  cattle  to  the  London  market. 
From  Yetminster,  he  removed  to  the  farm  of  Down- 
shay,  belonging  to  Mr.  Calcraft,  not  very  far  from 
Swanage.  There,  many  years  afterwards,  he  formed 
the  acquaintance  of  the  Rev.  Dr.  Bell,^  who  had  in- 
troduced the  practice  of  vaccination  into  Swanage. 
Jesty,  having  inoculated  his  wife  and  two  children  with 
Cow  Pox  in  1774,  became  anxious  that  his  claims  to 
the  original  discovery  should  be  known  ;  and  he 
accordingly  gave  Dr.  Bell  an  account  of  his  pro- 
ceedings, and  suggested  that  he  was  entitled  to  some 
reward  as  well  as  Jenner.  Dr.  Bell  was  much  struck 
with  Jesty's  narrative,  and  drew  up  the  following 
paper  on  the  subject,  though  he  was  afraid  that  Jesty 
was  too  late  in  making  his  claim,  as  he  had  not 
made  his  discovery  known  at  the  time,  and  had  only 
practised  inoculation  on   members  of  his  own  family. 

"  Of  the  Vaccine  Inoculation  as  performed  thirty  years  ago. 
1st  August,    1803. 

"The  inoculation  with  vaccine  matter,  as  taught  by  Dr.  Jenner 
and   diffused  over   the  globe   by   the    abiiit}',   industry,   and    well 


'  Southey.     The  Life  of  the  Rev.  Andrew  Bell,  vol.  ii.,  p. 


CO  IV  FOX  AND   SMALL  POX. 


directed  exertions  of  that  great  benefactor  of  the  human  race, 
now  rests  on  such  universal  experience  as  might  seem  to 
require  no  further  support  or  illustration.  Sir  Isaac  Newton,  Dr. 
Franklin,  Monsieur  Lavoisier  (or,  if  you  chose,  rather  Dr.  Black), 
and  Harvey,  could  not,  in  the  same  short  period,  boast  of  equal 
success  in  the  spread  of  their  respective  discoveries ;  still, 
however,  there  are  some  who  question  the  efficacy  of  vaccination 
as  a  preventive  of  the  Small  Pox. 

"  After  I  had  last  spring,  by  way  of  introducing  (for  that 
was  all  I  proposed  in  the  first  instance)  the  practice  into  this 
peninsula,  inoculated,  with  vaccine  matter  which  I  brought 
from  a  distance  of  five  hundred  miles,  upwards  of  three  hundred 
persons — men,  women,  and  children — in  my  insulated  parish 
and  neighbourhood  (Isle  of  Purbeck),  where  the  visitation  of 
Small  Pox  is  a  stranger,  having  only  occurred  twice  in  forty 
years,  once  by  infection,  and  once  by  inoculation,  I  have  the 
mortification  to  find  that  the  efficacy  of  this  disorder  is  still 
disputed,  and  that  parents  still  decline  to  submit  their  children 
to  this  simple  operation.  Even  learned  and  able  physicians 
have  argued  that  Dr.  Jenner's  discovery  is  not  of  sufficient 
standing  to  establish  that  the  vaccine  inoculation  is  a  security 
against  the  variolous  infection  for  a  longer  period  than  his 
practice  extends. 

"  It  may  not  therefore  be  altogether  useless  to  bring  forward 
a  fact  which,  in  an  earlier  stage  of  Dr.  Jenner's  practice,  would 
(had  it  been  known  to  him)  have  given  weight  to  his  doctrines, 
and  which  still  perhaps  may  be  thought  not  unworthy  of  a 
place  in  the  history  of  the  Cow  Pox.  If  it  should  have  any 
influence  with  those  parents  who  decline  the  offer  made  to  them 
of  having  their  children  vaccinated,  my  object  is  attained ;  and 
let  Mr.  Jesty  have  that  share  of  credit  (whatever  it  may  be) 
which  attaches  to  his  bold  and  successful  experiment. 

"In  the  spring  of  the  year  1774,  Farmer  Benjamin  Jesty, 
then  of  Yetminster  in  Dorset,  now  of  Downshay,  Isle  of  Purbeck, 
inoculated   with  vaccine   matter,  his   wife^  and  two  sons,   Robert 

'  He  is  said  to  have  had  the  infection  himself  by  casually  taking-  it 
from  the  cows  before  this. — Bell. 


TRADITIOXS   OF  THE  DAIRYMAIDS.  113 

and  Benjamin,  of  three  and  two  years  of  age,  and  all  three 
now  alive.  Mrs.  Jesty  was  inoculated  in  the  arm  under  the 
elbow,  her  sons  above  the  elbow.  The  incision  was  made  with 
a  needle,  and  the  virus  taken  on  the  spot  from  the  cows  of 
Farmer  Elford  of  Chittenhall,  whither  Mr.  Jesty  carried  his 
family  for  that  purpose.  The  sons  had  the  disorder  in  a 
favourable  way,  but  Mrs.  Jesty's  arm  was  much  inflamed ;  and 
the  boldness  and  novelty  of  the  attempt  produced  no  small 
alarm  in  the  family,  and  no  small  sensation  in  the  neighbour- 
hood. Fifteen  years  afterwards  (1789),  the  sons  were  inoculated 
for  the  Small  Pox  by  Mr.  Trowbridge,  surgeon,  of  Cerne 
Abbas,  along  with  others  who  had  not  had  the  Cow  Pox. 
The  arms  of  the  former  inflamed,  but  the  inflammation  soon 
subsided,  and  no  fever  or  other  variolous  symptom  was 
observable  ;  the  latter  went  through  the  fever  eruption  and 
usual  course  of  the  inoculated  Small  Pox.  Mrs.  Jesty  and  the  tw.o 
sons  have  often  since  been  exposed  to  the  variolous  contagion. 
"  It  may  be  inquired  by  the  future  historian  of  the  Cow  Pox 
what  led  to  this  early  essay  of  introducing  the  vaccine  virus 
into  the  human  frame  ?  and  how  it  happened  that  this  successful 
attempt  fell  still-born  from  the  cow  ?  Mr.  Jest3''s  relation  is  to 
this  effect : — 

"  When  the  Small  Pox  raged  in  the  vicinity  and  inoculation  was 
introduced  into  the  village  (Yetminster),  alarmed  for  the  safety  of 
his  family,  he  bethought  himself  of  this  expedient.  There  had 
been,  in  his  family,  two  maid  servants,  Ann  Notley  and  Mary  Read, 
who,  after  having  the  disorder  from  the  cows,  and  knowing  this  to 
be  a  preventive  of  the  Small  Pox,  had  attended,  the  one  her 
brother,  the  other  her  nephew,  in  the  natural  Small  Pox  without 
taking  the  infection.  This  circumstance  led  Mr.  Jesty  to  com- 
municate by  inoculation  the  disorder  of  the  cows  to  his  family. 
For  this  purpose  he  carried  them  to  the  field  of  a  neighbouring 
farm,  and,  as  has  been  related,  performed  the  operation  on  the 
spot. 

"  To  the  other  question,  how  did  it  happen  that  this  discovery 

expired  at  its  birth,  a  ready  solution  will  be  found  in  the  character 

of  the  ingenious  farmer,  whose  pursuits  were  widely  different  from 

those    of  medicine,  or  literature,   or   science,   and  in   the  natural 

VOL.  I.  <S 


114  COW  POX  AND   SMALL   POX. 

prejudice  of  mankind  strengthened  by  the  alarm  which  the  inflam- 
mation of  Mrs.  Jesty's  arm  had  excited.  To  such  a  height  was 
this  prejudice  carried  that  a  neighbouring  surgeon,  whose  name  I 
have  not  been  able  to  learn,  had  almost  lost  his  practice  from  the 
bare  proposal  of  following  up  Mr.  Jesty's  bold  and  successful 
experiment. 

"With  those  who  objected  to  introducing  the  bestial  disorder 
into  the  human  frame,  already  liable  to  so  many  diseases,  the 
farmer  has  been  heard  to  say  that  he  argued  after  this  manner : — 

"  For  his  part  he  preferred  taking  infection  from  an  innocuous 
animal  like  a  cow,  subject  to  so  few  disorders,  to  taking  it  from 
the  human  body,  liable  to  so  many  and  such  diseases  ;  and  that  he 
had  experience  on  his  side,  as  the  casual  Cow  Pox  was  not 
attended  with  danger  like  the  variolous  infection  ;  and  that  beside, 
there  appeared  to  him  little  risk  in  introducing  into  the  human 
constitution  matter  from  the  cow,  as  we  already  without  danger 
eat  the  flesh  and  blood,  drink  the  milk,  and  cover  ourselves  with 
the  skin  of  this  innocuous  animal." 

This  Statement  was  forwarded  some  time  afterwards 
to  the  Jennerian  Society,  and  a  copy  was  also  sent 
to  the  Right  Hon.  George  Rose.  In  a  note  accom- 
panying the  latter,   Dr.    Bell  said  : — 

"  If  you  think  it  worth  the  previous  notice  of  your  friends,  Mr. 
Pitt,  Sir  H.  Mildmay,  etc.,  or  of  being  otherwise  disposed  of,  you 
have  my  leave.  I  have  many  apologies  to  offer  for  obtruding 
upon  you  at  this  time,  but  as  this  affair  has  long  lain  dormant, 
and  is  now  to  be  forwarded  to  the  R.J.S.,  I  am  exceedingly 
desirous  of  presenting  to  you  this  simultaneous  communication." 

An  answer  was  returned  by  the  secretary  of  the 
Jennerian  Society,  stating  "  that  he  had  received  Dr. 
Bell's  very  interesting  paper  of  the  vaccine  inoculation, 
and   that  he  should   have    an    opportunity    of  laying    it 


2RADITI0NS   OF  THE  DAIRYMAIDS.  115 

before  the  two  boards  at  their  meeting  on  the  following 
evening."  At  the  time  that  Dr.  Bell  drew  up  this 
statement,  he  was  not  aware  of  Dr.  Pearson's  pam- 
l)hlet,  in  which  Mr.  Jesty's  name  had  already  been 
mentioned. 

Indeed,  Dr.  Bell  had  obtained  his  information 
direcdy  from  Mr.  Jesty,  and  quite  independendy  of 
Dr.  Pearson ;  and  this  is  sufficient  to  show  how 
utterly  unjustifiable  was  Jenner's  view  that  the  whole 
story  was  a  "  trick  "  invented  by  Pearson.  Dr.  Pear- 
son's publication  fell  into  Dr.  Bell's  hands  shortly 
afterwards,  and  he  wrote  immediately  to  the  Secretary 
of  the  Jennerian  Society  : — 

"  Central  House,  Salisburv  Square, 
"  JiUy  yih,  1804. 

"SiR,^ — In  Dr.  Pearson's  pamphlet  which  has  just  been  put 
into  my  hands,  I  read  as  follows  :  — '  Mr.  Justins  '  (a  mistake  for 
Jesty),  '  a  farmer  of  Yetminster  in  Dorset,  inoculated  his  wife  and 
family  with  matter  taken  from  the  teat  of  a  cow  that  had  the 
Cow  Pox.  In  about  a  week  from  the  time  of  inoculation,  their 
arms  were  very  much  inflamed,  the  patients  were  very  ill,  and  the 
man  was  so  much  alarmed  as  to  call  in  medical  assistance  (Mr. 
Read,  of  Cerne).  The  patients  soon  got  well,  and  they  have  since 
been  inoculated  for  the  Small  Pox  by  Mr.  Trowbridge,  of  Cerne, 
but  without  effect.' 

'"I  cannot  inform  you  at  what  period  Mr.  Justins  inoculated  his 
family,  but  I  have  no  doubt  it  was  previous  to  Dr.  Jenner's 
practice. 

"'The  farmer  alluded  to  in  Mr.  Pulteney's  letter  to  you,  who 
inoculated  his  wife  and  children  with  matter  taken  from  a  cow, 
and  the  person  mentioned  in  Mr.  Drew's  letter,  viz.,  Mr.  Justins, 
is  the  same  person.  Both  Mr.  Pulteney's  and  Mr.  Drew's  intelli- 
gence came  from  me,  I  am  not  certain  at  this  time  as  to  the  year, 


:i6  CO  TV  FOX  AND  SMALL  POX. 


but  I  believe  it  was  on  or  before  the  year   1786.     The  farmer  is 
still  living,  of  whom  I  can  have  the  particulars. 

"  *  In  a  subsequent  letter  to  Dr.  Pearson,  dated  Chattle 
June  15th,  1802,  Mr,  Dolling  informed  him  that  Mr.  Benjamin 
Jesty  (not  Justins)  performed  the  inoculation  above  mentioned  as 
early  as  1774,^  and  he  is  still  living. 

" '  I  know  a  medical  man  in  this  country  who  was  greatly 
injured  in  his  practice  by  a  prejudice  raised  against  him  long  ago 
for  his  intention  of  substituting  the  Cow  Pox  for  the  Small  Pox.' 

"These  extracts,  had  I  seen  Dr.  Pearson's  pamphlet,  should 
have  preceded  the  statement  which  I  forwarded  to  you  in  my  late 
letter,  and  you  will  perhaps  agree  with  me  in  opinion  that  they 
should  still  be  subjoined  in  a  note.  The  facts  which  I  have 
detailed  were  communicated  to  me  by  the  parties  themselves,  and 
their  accuracy  may  be  depended  on." 

Mr.  Banks,  the  member  for  Corfe  Castle,  wrote 
to   Dr.   Bell  on  the  same  subject : — 

"  October  i6ih,  1804. 
"  Sir, — A  fact  relating  to  a  farmer  in  Dorsetshire,  which  I  take 
to  be  the  same  that  is  mentioned  in  the  enclosed  papers,^  given 
in  evidence  before  the  committee  of  the  House  of  Commons,  to 
whom  Dr.  Jenner's  petition  was  referred,  and  if  1  am  not  mistaken 
was  printed  in  their  report.  There  was,  I  am  sure,  abundant 
proof  of  the  disorder  being  known,  and  of  its  preventive  power, 
long  before  Dr.  Jenner's  name  was  heard ;  nor,  at  this  moment,  do 
those  who  continue  to  doubt  the  complete  efficacy  of  the  Cow  Pock 
deny  its  success  in  innumerable  instances." 

The  Jennerian  Society  now  became  desirous  of 
seeing  Mr.  Jesty,  and  an  endeavour  was  made  to 
induce   him     to    go     up     to     London ;    but,    fearing    an 

'  "  Dr.  Jenner  is  said  first  to  have  considered  the  subject  in  177s,  but  it 
was  not  until  1796  that  he  made  his  first  experiment." — Bell. 
-  Dr.  Bell's  statement. 


TRADITIONS  OF  THE  DAIRYMAIDS.-  117 


attack  of  gout,  to  which  he  was  subject,  he  declined 
to  undertake  the  journey.  In  the  course  of  the  next 
year,  the  following  letter  was  addressed  to  him  by  the 
secretary  of  the  society  : — 

"  London,  July  z^ih,  1805. 
"Sir, — I  am  desired  by  the  medical  establishment  of  this  insti- 
tution to  propose  to  you  that,  provided  you  will  come  to  town  at 
your  own  convenience,  but  as  soon  as  possible,  to  stay  not  longer 
than  five  days,  unless  you  desire  it,  for  the  purpose  of  taking 
your  portrait  as  the  earliest  inoculator  for  Cow  Pock,  at  the 
expense  of  the  institution,  you  will  receive  15  guineas  for  your 
expenses,  and  the  members  of  the  establishment  will  be  happy  to 
show  you  any  civility  during  your  stay  in  London,  on  which 
account  it  is  hoped  you' will  be  put  to  little  or  no  expense. 
"  I  have  the  honour  to  remain,  Sir, 

"Your  Obedient,  Humble  Servant, 

"Will  Sancho." 

Mr.  Jesty  accepted  this  invitation,  taking  with  him 
his  son   Robert,  whom  he  had  inoculated    in   1774. 

"  They  met  with  great  attention  from  the  members  of  the 
society,  who  were  much  amused  with  Jesty's  manners  and 
appearance.  Before  he  left  home,  his  family  tried  to  induce  him  to 
attire  himself  somewhat  more  fashionably,  but  without  effect. 
'  He  did  not  see,'  he  said,  '  why  he  should  dress  better  in  London 
than  in  the  country ; '  and  accordingly  wore  his  usual  dress, 
which  was  peculiarly  old-fashioned.  In  order  to  prove  their 
statement,  Mr.  Robert  Jesty  willingl}'  consented  to  be  inoculated 
for  the  Small  Pox,  and  his  father  for  the  Cow  Pock,  but  neither 
took  effect. 

"  Mr.  Jesty  was  presented  with  a  pair  of  very  handsome  gold- 
mounted  lancets,  and  his  portrait  was  also  taken  by  Mr.  Sharpe ; 
but  he  proved  an  impatient  sitter,  and  could  only  be  kept  quiet  by 
Mrs.  Sharpe's  playing  to  him  on  the  piano." 


ii8  COW  FOX  AND   SMALL  FOX. 


The  portrait,  from  which  an  engraving  was  made, 
was  exhibited  at  Somerset  House,  and  afterwards 
placed  in  the  Vaccine  Institution  ;  it  then  fell  into  Dr. 
Pearson's  hands,  and  on  his  death,  passed  to  his 
son-in-law,  who,  finding  that  Jesty's  family  were 
anxious  to  possess  it,  presented  it  to  Robert  Jesty. 
After  Robert  Jesty's  death,  the  portrait  remained 
with  his  widow  for  a  time  at  Wraxall  House,  near 
Maiden   Newton. 

During  my  inquiries  in  Dorsetshire,  early  in  1888,  I 
was  fortunate  enough  to  obtain  one  of  the  original 
engravings,  made  from  this  portrait,  of  which  the 
frontispiece  is  a  reduced  fac-simile.  I  also  ascertained 
that  the  portrait  was  in  the  possession  of  Jesty's 
great-grandson,  Mr.  Frank  Pope,  of  Chilfrome,  near 
Dorchester  ;  I  thus  had  an  opportunity  of  seeing 
the  portrait,  and  of  acquiring  much  interesting  in- 
formation. 

The  following  statement  was  also  drawn  up  and 
signed  by  the  members  of  the  Jennerian  Society,  and 
presented  with  the  portrait  : — 

"  Mr.  Benjamin  Jesty,  farmer,  of  Downshay,  in  the  Isle  of 
Purbeck,  having,  agreeable  to  an  invitation  from  the  Medical 
establishment  of  the  Original  Vaccine  Pock  Institution,  Broad 
Street,  Golden  Square,  visited  London  in  August,  1805,  to  com- 
municate certain  facts  relating  to  the  Cow  Pock  Inoculation,  we 
think  it  a  matter  of  justice  to  himself  and  beneficial  to  the  Public, 
to  attest  that,  among  other  facts,  he  has  afforded  decisive  evidence 
of  his  having  vaccinated  his  wife  and  two  sons,  Robert  and  Ben- 
amin,  in  the  year  1774,  who  were  thereby  rendered  unsusceptible 


TRADITJONS  OF  THE  DAIRYMAIDS. 


of  the  Small  Pox,  as  appears  from  the  exposure  of  all  the  parties  to 
that  disease  frequently  during  the  course  of  thirty-one  years,  and 
from  the  inoculation  of  the  two  sons  for  the  Small  Pox  fifteen  years 
ago.  That  he  was  led  to  undertake  this  novel  practice  in  1774,  to 
counteract  the  Small  Pox  at  that  time  prevalent  where  he  then 
resided,  from  knowing  the  common  opinion  of  the  country  ever 
since  he  was  a  boy,  now  about  sixty  years  ago,  that  persons  who 
had  gone  through  the  Cow  Pox  naturally  (/'.t'.)  by  taking  it  from  the 
cows,  were  unsusceptible  of  the  Small  Pox  ;  b}-  himself  being 
incapable  of  taking  the  Small  Pox,  by  having  gone  through  the  Cow 
Pox  many  years  before;  from  having  personally  known  many  indi- 
viduals who,  after  the  Cow  Pox,  could  not  have  the  Small  Pox 
excited  ;  from  believing  that  the  Cow  Pox  was  an  aifection  free 
from  danger ;  and  from  his  opinion  that  by  the  Cow  Pock  inocu- 
lation he  should  avoid  engrafting  various  diseases  of  the  human 
constitution — such  as  the  evil,  madness,  lues,  and  many  bad 
humours,  as  he  called  them. 

"  The  remarkably  vigorous  health  of  Mr.  Jesty's  wife  and 
two  sons,  now  thirty-one  years  subsequent  to  the  Cow  Pox,  and 
his  own  healthy  appearance,  at  this  time  seventy  years  of  age, 
afford  a  singular  proof  of  the  harmlessness  of  that  affection.  But 
the  public  must,  with  particular  interest,  hear  that  during  their  late 
visit  to  town,  Mr.  Robert  Jesty  very  willingly  submitted  publicly 
to  inoculation  for  the  Small  Pox  in  the  most  rigorous  manner,  and 
that  Mr.  Jesty  also  was  subjected  to  the  trial  of  inoculation  for  the 
Cow  Pock  after  the  most  efficacious  mode,  without  either  of  them 
being  infected. 

"  The  circvmistances  in  which  Mr.  Jesty  purposely  instituted 
the  vaccine  pock  inoculation  in  his  own  family — viz.,  without  any 
precedent,  but  merely  from  reasoning  upon  the  nature  of  the  affec- 
tion among  cows,  and  from  knowing  its  effects  in  the  casual  way 
among  men,  his  exemption  from  the  prevailing  popular  prejudices, 
and  his  disregard  of  the  clamorous  reproaches  of  his  neighbours,  in 
our  opinion  will  entitle  him  to  the  respect  of  the  public  for  his 
superior  strength  of  mind ;  but,  further,  his  conduct  in  again  fur- 
nishing such  decisive  proofs  of  the  permanent  anti-variolous  efficacy 
of  the  Cow  Pock,  in  the  present  discontented  state  of  many  families, 
by  submitting  to  inoculation,  justly  claims  at  least  the  gratitude  of 


cow  POX  AND   SMALL   POX. 


the  country.  As  a  testimony  of  our  personal  regards,  and  to 
commemorate  so  extraordinary  a  fact  as  that  of  preventing  the 
Small  Pox  by  inoculation  for  the  Cow  Pock  thirty-one  years  ago, 
at  our  request  a  three-quarter  length  picture  of  Mr.  Jesty  is 
painted  by  that  excellent  artist  Mr.  Sharpe,  to  be  preserved  at  the 
original  Vaccine  Pock  Institution. 

Physicians.  Consulting  Surgeons.             Surgeons. 

George  Pearson,         Wheate,  Joseph  Constantine, 

L.  Nitell,  F.  Foster.  Carpue, 

Thos.  Nelson.  J.  Doratt. 

Visiting  Apothecaries.  Treasurers. 

Fra.  Rivers,  J.  Heaviside, 

Everard  A.  Brande,  T.  Payne." 
Philip  de  Bruyn. 

Jesty's  visit  to  London  had  satisfactorily  established 
his  claim  as  the  first  inoculator  of  Cow  Pox,  but  there 
the  matter  ended  ;  and  while  he  was  in  London  he 
does  not  seem  to  have  pressed  for  any  pecuniary  reward. 
The  following  year,  however,  he  wrote  to  Dr.  Pearson 
on  the  subject,  and  his  letter  was  communicated  to 
the  members  of  the  Institution.  The  secretary  wrote 
to  Jesty  in  answer,  stating  that  they  would  endeavour 
to  promote  his  views,  but  they  were  afraid  it  was  very 
improbable  that  any  such  reward  would  be  obtained. 
After  this,  Jesty  gave  up  all  expectations  ;  and  his 
circumstances  were  such  as  to  render  it  a  matter  ot 
little   inij)ortance. 

But  the  interest  of  his  family  in  the  subject  did  not 
on   that  account  cease.      His  son    Benjamin   became  an 


TRADITIONS   OF  THE  DAIRYMAIDS. 


enthusiast  in  the  cause  of  Cow  Pox  inoculation.  In 
the  year  1809,  he  is  said  to  have  performed  the  opera- 
tion on  great  numb(;rs,  and  to  have  kept  a  regular 
register  of  the  names  of  the  individuals,  and  of  the 
progress  of  the  disorder   in   each. 

There  is  also  additional  local  evidence,  nrovino-  the 
accuracy  of  Dr.  Bell's  account,  in  a  letter  written  by  the 
Rev.  J.  M.  Colson,  of  Swanage,  to  the  Rev.  F.  F.  Tracy. 

^^ February  \6tli,  i860. 
"  My  Dear  Sir, — "  I  have  a  perfect  recollection  of  old  Jesty 
coming  to  our  house  at  Corfe,  the  one  now  inhabited  by  Mr. 
Bradley,  to  borrow  of  my  father  a  pair  of  saddle-bags  to 
contain  his  clean  shirts  when  he  was  going  to  London  to 
give  evidence  on  his  discovery  of  vaccination,  and  being 
vice  the  saddle-bags  (a  thing  of  bygone  ages,  now  quite 
an  extinctmn  genus),  supplied  with  a  portmanteau  as  a  more 
convenient  vehicle.  On  his  return,  he  gave  a  very  unfavour- 
able report  of  the  metropolis  ;  but,  per  contra,  said  there  was  one 
great  comfort  there  indeed — viz.,  that  he  could  be  shaved  every  day, 
instead  of  wearing  his  beard  from  Saturday  to  Saturday,  on  which 
day  alone — when  he  rode  into  Wareham  market — was  he  relieved 
of  that  encumbrance  (as  it  was  then  thought,  noiv,  fenipura 
miitaiitiir).  I  cannot  precisely  date  this  event.  We  lived  at  Corfe 
from  May  1800  till  October  18 10,  and  my  belief  is  that  it  must 
have  been  about  1805,  6,  or  7.  Some  years  before  this,  he  had 
lived  at  a  farm  in  the  neighbourhood  of  Cerne,  of  this  county 
(Dorset),  and  there  he  first  practised  vaccination  on  his  own  chil- 
dren. Fever  ran  high  with  his  patients,  and  he  called  in  Mr. 
Trowbridge,  the  medical  man  of  Cerne  (whom  I  full  well  remember 
in  later  years  when  we  lived  near  that  place),  and  told  him  what 
he  had  done.  Trowbridge  said,  '  You  have  done  a  bold  thing,  but 
I  will  get  3'ou  through  it  if  I  can  ; '   treated  it  as  fever,  and  was 

'  Papers  read  before  the  Purbeck  Society,  p.  244.     i86o. 


CO IV  POX  AND  SMALL   POX. 


successful.  I  should  have  said  that  old  Jesty,  not  being  equipped 
with  a  lancet,  performed  the  operation  with  a  stocking  needle!  !  .  .  . 

"  Believe  me, 

"  Truly  yours, 

"J.    M.    COLSON." 

Jesty  died  in  1816,  and  v^as  buried  in  the  church- 
yard of  Worth  Matravers,  near  Swanage.  On  the 
tombstone  is  the  following  inscription  : — 

Sacred 
To   the  Memory 

of 

BENJN.    JESTY    (of   DOWNSHAY), 

Who  departed  this  life 

April    1 6th,    18 16, 

Aged  79  Years. 

He  was  born  at  Yetminster  in  this  County,  and  was  an  upright 
honest  man  ;  particularly  noted  for  having  been  the  first  Person 
(known)  that  introduced  the  Cow  Pox  by  inoculation,  and  who, 
from  his  great  strength  of  mind,  made  the  experiment  from  the 
Cow  on  his  wife  and  two  sons  in  the  year  1774. 


The  anxiety  which  Jesty  must  have  felt  when  his 
inoculations  were  in  progress,  can  be  well  understood  in 
the  light  of  later  experiences.  Those  severe  symptoms 
occurred,  which  have  so  commonly  followed  the  use 
of  lymph  direct  from  the  cow.  Fever  ran  high  with 
his  patients,  and  he  was  obliged  to  call  in  medical 
aid  ;  in  fact,  he  met  with  similar  occurrences  to  those 
which  many  years  afterwards  alarmed  Jenner,  Bousquet, 
Estlin,  and  others  to  whose  lot  it  has  fallen  to  observe 
the  full  effects  of  the  Cow  Pox  virus. 


TRADITIONS   OF   TIIK  DAIRYMAIDS.  123 

Mrs.  Jesty,  who  was  thus  the  first  person  known 
to  have  been  intentionally  Cow  Poxed,  not  only  re- 
covered from  the  operation,  but  lived  to  the  age  of 
eighty-four,  a  result  which  if  it  was  not  actually 
credited  to  the  beneficial  effects  on  the  constitution 
alleged  to  follow  the  operation,  was  certainly  testimony 
that  it  had  produced  no  permanent  ill  effects. 


Elizabeth  jEbXV.     Inoculated  with  Cow  Pox  in  1774. 

Mrs.  Jesty  was  buried  by  the  side  of  her  husband 
in  the  churchyard  of  Worth  Matravers,  and  her  tomb- 
stone bears  the  following  inscription  : — 

Sacred  to    tin: 

Memory  of 

ELIZABETH    JESTY, 

Relict  of  the  late 

BENJAMIN  JESTY, 

of   Downshay,    who    departed 

this  life,  Jan.  8,  1824, 

Aged  84  Years. 


124  cow  POX  A  AW   SAIALL   POX. 

To  the  descendants  of  Jesty,  still  living  in  Dorset- 
shire, I  am  indebted  for  the  copy  of  the  portrait  of 
Mrs.  Jesty,  which  is  here  reproduced.  It  affords  addi- 
tional evidence  of  the  fact  that  the  above  accounts 
are  records  of  persons  whose  existence  was  not  merely 
imaginary. 


CHAPTER  VI. 

LIFE   AND    LETTERS    OF   EDWARD    'JENNER. 

Edward  Jenner  was  a  nativ^e  of  Berkeley,  in  Glou- 
cestershire. He  was  born  in  1749,  and  was  the  third 
son  of  the  Rev.  Stephen  Jenner,  jNI.A,,  Vicar  of 
Berkeley.  Jenner's  father  had  been  tutor  to  a  former 
Earl  of  Berkeley,  who  had  a  great  regard  for  all  the 
family. 

In  the  Berkeley  manuscripts,  published  by  Thomas 
Dudley  Fosbrooke  in  1821.  it  is  remarked  that  the 
foundations  for  Jenner's  subsequent  investigations  on 
the  subject  of  protection  from  Small  Pox,  were  probably 
laid  in  an  early  period  of  his  life.  He  was  eight 
years  of  age  when  he  was  put  under  the  preparatory 
reofimen  for  inoculation.  This  lasted  tor  six  weeks, 
during  which  time  he  was  bled,  purged,  kept  on 
very  low  diet,  and  dosed  with  "  a  diet  drink  to 
sweeten  the  blood."  After  this  "  he  was  removed 
to  one  of  the  then  usual  inoculation  stables,  and 
haltered  up  with  others  in  a  terrible  state  of  disease, 
although  none  died."      By  good  fortune,  Jenner  escaped 


126  EDWARD  JENNER. 

with  a  mild  attack.  Such  is  the  incident  on  which 
Fosbrooke  felt  justified  in  making  the  following 
comment : — 

"  It  is,  without  superstition,  a  noticeable  incident  in  a  bio- 
graphical account  that  the  misery  endured  in  the  Small  Pox 
process  should  have  laid  the  foundation  for  the  extermination  of 
the  disease,  and  it  is  strongly  indicative  of  a  philosophical  bias  in 
the  character.  It  exhibits  impression  accompanied  with  reflection, 
and  a  view  to  the  removal  of  the  evil.  Whereas  common  man 
takes  such  incidents  as  usual  inevitable  occurrences,  feels  irrit- 
able, swears  stoutly,  and  then  forgets." 

Shortly  afterwards,  Jenner  was  sent  to  school  at 
Cirencester,  where  he  stayed  half  a  year;  but  his  health 
not  being  reinstated,  he  was  placed  with  a  private  tutor. 
The  effect  of  the  preparation  and  inoculation  was  said 
to  be  this  :  "  As  a  child  he  could  never  enjoy  sleep, 
and  was  constantly  tormented  by  imaginary  noises 
and  a  sensibility  too  acutely  alive  to  these,  and  sudden 
jars  subsisted  through  many  years."  As  a  schoolboy, 
Jenner  is  said  to  have  been  "  enamoured  of  natural 
history,"  as  evidenced  by  his  possessing  a  dormouse, 
and  making  a  collection  of  birds'  nests.  At  thirteen 
years  of  age,  Jenner  was  placed  under  the  care  of 
the  Messrs.  Ludlow,  then  eminent  practitioners  at 
Sodbury,  near  Bristol,  and  remained  with  them  six 
years.  It  was  during  his  apprenticeship  there,  that, 
according  to  Baron,  an  incident  happened  which  laid 
the  loundation  of  Jenner's  future  observations. 

"  It  has  been  stated  that  his  attention  was  drawn  forcibly  to  the 


LIFE  AND  LETTERS.  127 


nature  of  Cow  Pox  while  he  was  yet  a  youth.  The  event  was 
brought  about  in  the  following  manner  : — He  was  pursuing  his 
professional  education  in  the  house  of  his  master  at  Sodbury ;  a 
young  countrywoman  came  to  seek  advice ;  the  subject  of  Small 
Pox  was  mentioned  in  her  presence  ;  she  immediately  observed, 
'  I  cannot  take  that  disease,  for  I  have  had  Cow  Pox.'  This 
incident  rivetted  the  attention   of  Jenner." 

That  such  an  event  occurred  is  extremely  pro- 
bable, for  the  famous  tradition  was  part  of  the  stock 
gossip  of  the  dairymaids,  and  was  well  known  to 
many  practitioners  in  dairy  districts.  But  if  it 
"  rivetted  the  attention  of  Jenner  "  at  this  period,  it  is 
somewhat  extraordinary  that  Fosbrooke  should  have 
made  no  allusion  to  such  an  interesting  incident, 
especially  as  the  first  biography  was  written  during 
Jenner's  life,  and  the  anecdotes  it  contained  were 
written  on  authority.  Baron  nevertheless  attributes 
the    greatest    importance    to    this    incident. 

"  Newton  had  unfolded  his  doctrine  of  light  and  colours  before 
he  was  twenty ;  Bacon  wrote  his  Temporis  Partus  Maximus 
before  he  attained  that  age  ;  Montesquieu  had  sketched  his  Spirit 
of  Laivs  at  an  equally  early  period  of  life  ;  and  Jenner,  when  he 
was  still  younger,  contemplated  the  possibility  of  removing  from 
among  the  list  of  human  diseases  one  of  the  most  mortal  that  ever 
scourged  our  race." 

Jenner's  hypochondriacal  habit,  attributed  to  the 
Small  Pox  inoculation,  still  existed  at  this  period, 
though  it  is  said  to  have  gradually  diminished.  After 
the  usual  course  of  instruction  in  materia  medica  and 
surgery,    Jenner    became,     at    the    age    of  twenty-one, 


EDWARD  JENNER. 


house  pupil  to  John  Hunter,  and  is  said  to  have 
mentioned  the  subject  of  Cow  Pox  to  him.  He 
assisted  him  in  forming  his  valuable  museum,  and  on 
his  return  to  Berkeley,  undertook  anatomical  and 
physiological  researches  (suggested  by  Hunter),  while 
he  at  the  same  time  commenced  practice.  It  was  at 
this  stage,  we  are  told,  that  the  first  great  event  of 
his  professional  career  occurred.  During  the  indis- 
position of  the  senior  surgeon  of  the  Gloucester 
Infirmary,  he  operated  with  success  on  a  case  of 
strangulated    hernia. 

Jenner  was  also  interested  in  pharmaceutical  chemistry, 
and  as,  in  his  experience,  some  of  the  preparations  were 
by  no  means  perfect,  he  was  led  to  investigate  them. 
This  was  particularly  the  case  with  tartar  emetic. 
He  wrote  a  small  pamphlet  on  the  subject,  apparently 
his  earliest  publication,  and  he  also  communicated 
the  results  of  his  inquiries  to  Hunter,  which  were 
acknowledged  in  the  following  letter  ^ : — 

Mr.  Hunter  to  E.  Jenner. 
"Dear  Jenner, — 
"  I  am  puffing  off  your  tartar,  as  the  tartar  of  all  tartars,  and 
have  given  it  to  several  physicians  to  make  trial,  but  have  had 
no  account  yet  of  the  success.  Had  you  not  better  let  a  bookseller 
have  it  to  sell,  as  Glass  of  Oxford  did  his  magnesia  ?  Let  it  be 
called  Jenner's  Tartar  Emetic,  or  any  body's  else  you  please. 
If  that  mode  would  do,  I  will  speak  to  some,  viz.  Newbery,  etc. 
You  are  very  sly,  although  you  think  1  cannot  see  it :  you  very 
modestly  ask  for  a  thermometer;  I  will  send  one,  but  take  care 


The  original  letter  is  in  the  library  of  the  Royal  College  of  Surgeons. 


LIFE  A. YD  LETTERS.  129 


that  those  d d  clumsy  fingers  do  not  break  it  also.     I  should 

be  glad  to  have  a  true  and  particular  account  of  the  cuckoo,  and 
as  far  as  possible  under  your  own  eye.  To  put  all  matters  out 
of  dispute,  if  the  cuckoo's  eggs  were  taken  out  of  the  hedge- 
sparrow's  nest  in  which  they  were  laid,  and  put  into  another 
by  human  hands,  there  could  be  no  supposition  that  the  parent 
cuckoos  would  feed,  or  take  an}-  care  of  them.  1  also  want  some 
young  ones.  I  had  a  series  from  you,  but  a  moth  got  in  among 
them,  and  plucked  them. 

"Let  me  hear  from  you  when  you  can. 

"  Yours, 

"  J.  Hunte:r." 

Jenner  made  some  original  observations  on  the 
natural  history  of  the  cuckoo,  which  he  made  the 
subject  of  a  paper  for  the  Royal  Society.  It  was 
returned  with  a  letter  from  Sir  Joseph  Banks,  who 
wrote  : — 

"  In  consequence  of  you  having  discovered  that  the  young 
cuckoo,  and  not  the  parent  bird,  removes  the  eggs  and  young 
from  the  nest  in  which  it  is  deposited,  the  council  thought  it  best 
to  give  you  a  full  scope  for  altering  it,  as  you  shall  choose. 
Another  year  we  shall  be  glad  to  receive  it  again  and  print  it. 
Your  other  papers  I  hope  you  will  proceed  with,  when  your 
leisure   allows  you  opportunity." 

The  paper  was  finally  read  on  March  13th,  1788,  and 
published  in  the  Philosophical  Transactions  for  that 
year.     According  to  Fosbrooke 

"  It  proved  the  very  singular  fact  that  the  infant  cuckoo  reared 
from  the  egg  in  the  sparrow's  nest  expelled  the  young  of  that 
bird  by  placing  them  upon  its  shoulder,  on  a  depression,  which 
Nature  gives  for  the  purpose,  on  the  back  of  the  unfledged 
cuckoo,  and  throwing  them  out  of  the  nest.     There  are  also  other 

VOL.    I.  9 


130  EDWARD  yENNER. 


phenomena  never  before  noticed.  These  curious  incidents  were 
affirmed  by  Pennant  to  have  eluded  research  from  the  time  of 
Aristotle." 

On  the  continent,  the  paper  appears  to  have  been 
read  with  interest,  and  to  have  received  the  highest 
praise  from  at  least  one  person.  In  a  postscript, 
Blumenbach  wrote  to  Jenner  : — 

"  Give  me  leave,  Sir,  to  tell  you  also  that  I,  as  a  very  warm 
friend  and  even  teacher  of  Natural  History,  long  very  eagerly 
to  see  at  once  your  paper  on  the  migration  of  birds,  mentioned  in 
your  masterly  observations  on  the  cuckoo." 

After  the  pubHcation  of  this  paper,  Jenner  was  elected 
a  Fellow  of  the  Royal  Society.  Soon  afterwards  he 
was  married  to  Miss  Kathleen  Kingscote,  and  he  was 
assisted  in  his  practice  by  his  nephew,  Henry,  whom  he 
had  taken  as  his  apprentice.  From  the  proceeds  of  his 
practice,  and  a  patrimonial  inheritance,  Jenner  in  1792 
took  out  a  diploma.  He  then  settled  down  in  Chauntry 
Cottage,  Berkeley,  where  he  devoted  a  good  deal  of 
his  spare  time  to  landscape  gardening.  In  1794,  he  had 
a  severe  attack  of  typhus,  and  was  confined  to  his  house 
by  debility  till  the  spring  of  1795.  He  removed  to 
Cheltenham  during  the  season,  and  was  occasionally 
called  in  consultation  by  local  practitioners.  From 
?""osbrooke  we  learn  that 

"  it  was  chiefly  during  these  periods  of  residence  in  Berkeley 
and  Cheltenham  (because  he  was  not  then  burdened  with  the 
labours  which   vaccine  has   generated)    that  Dr.  Jenner  used   to 


LIFE  AND  LETTERS.  131 

amuse  himself  with  extemporaneous  eflfusions  in  poetry,  not 
intended  for  the  press.  In  this  way  his  taste  generally  took 
an  epigrammatical  turn,  but  was  strictly  confined  to  harmless 
gentlemanly   facetiousness." 

The  statement  of  Fosbrooke,  that  up  to  the  year 
1795,  Jenner  was  not  burdened  with  the  labours  which 
vaccine  had  generated,  is  important,  and  leads  one  to 
ask  how  it  is  that  the  Inquiry,  published  in  1798,  has 
been  described  by  Simon  ^  as  the  outcome  of  thirty 
years  of  incessant  thought,  watching,  and  experiment. 

"  Thirty  years  elapsed  before  the  fruit  was  borne  to  the  public  ; 
but  incessantly  he  thought,  and  watched,  and  experimented  on  the 
suhject." 

Baron  is  responsible  for  this  illusion.  The  incident  at 
Sodbury,  in  1770,^  was  credited  with  riveting  the  atten- 
tion of  Jenner.  When  Jenner  returned  from  London  and 
settled  in  practice,  his  attention  was  again  drawn  to  the 
subject  of  Cow  Pox,  and  it  is  stated  that  in  1780,  he 
conversed  on  the  subject  with  his  triend  Gardner. 
Baron^  gave  the  following  account  of  this  conversation: 

"It  was  not  till  1780  that  he  was  enabled,  after  much  study 
and  inquiry,  to  unravel  many  of  the  perplexing  obscurities  and 
contradictions  with  which  the  question  was  enveloped,  and  which 
had  impressed  those  who  knew  the  traditions  of  the  country  with 
the  opinion  that  it  defied  all  accurate  and  satisfactory  elucidation. 
In  the  month  of  May  of  the  year  just  mentioned,  he  first  disclosed 
his  hopes  and  his  fears  respecting  the  great  object  of  his  pursuit, 

•  Simon.     Papers  relati7ig  to  the  History  of  Vaccination ,  185;. 
-    Vide,  p.  127. 
'  Baron,  loc.  cit. 


EDWARD  JENNER. 


to  his  friend  Edward  Gardner.     By  this  time  Jenner's  mind  had 
caught  a  ghmpse  of  the  reputation  which  awaited  him,  but  it  was 
still  clouded  by  doubts  and  difficulties.     He  then  seemed  to  feel 
that  it  might,  in  God's  good  providence,  be  his  lot  to  stand  between 
the  living  and   the  dead,  and  that  through   him  a  plague  might  be 
stayed.     On  the  other  side,  the  dread  of  disappointment,  and  the 
probability  of  failing  to  accomplish   his  purpose,  restrained   that 
eagerness  which  otherwise  would  have  prompted  him  prematurely 
to  publish  the  result   of  his  inquiries,  and  thereby,  probably,  hy 
conveying  insufficient  knowledge,  blight  for  ever  his  favourite  hope. 
"  He  was  riding  with  Gardner,  on  the  road  between  Gloucester 
and  Bristol,  near  Newport,  when  the  conversation  passed  of  which 
I  have  made  mention.     He  went  over  the  natural  history  of  Cow 
Pox ;  stated  his    opinion  as  to  the  origin  of    this  affection   from 
the  heel  of  the  horse  ;  specified  the  different  sorts  of  disease  which 
attacked   the   milkers  when    they   handled    infected    cows  ;    dwelt 
upon  that  variety  which  afforded  protection  against  Small    Pox; 
and  with  deep  and  anxious  emotion  mentioned  his  hope  of  being 
able  to  propagate  that  variety  from  one  human  being  to  another, 
till  he  had  disseminated  the  practice  all  over  the  globe,  to  the  total 
extinction   of  Small    Pox.       The  conversation   was   concluded    by 
Jenner    in  words    to    the    following    effect  : — *  Gardner,    I     have 
entrusted  a  most  important  matter  to  you,  which  I  firmly  believe 
will   prove  of  essential  benefit  to  the  human  race.      I  know  you, 
and  should   not  wish  what  I  have  stated   to   be  brought  into  con- 
versation ;  for  should  anything  untoward    turn  up  in  my  experi- 
ments, I  should  be  made,  particularly  by  my  medical  brethren,  the 
subject  of  ridicule,  for  I  am  the  mark  they  all  shoot  at." 

Jenner  was  evidently  much  interested  in  the  natural 
history  of  Cow  Pox,  and,  in  1787,  it  is  related  that 
his  nephew,  George  Jenner,  accompanied  him  into  the 
stable  to  look  at  a  horse  with  diseased  heels.  "  There," 
said  Jenner,  pointing  to  his  horse's  heels,  "is  the  source 
ot  Sinall  Pox.  I  have  much  to  say  on  that  subject, 
which    I    hope  in  due  time  to  s^ive  to  the  world." 


LIFE  AND  LETTERS.  133 

In  1788,  Jenner  took  a  drawing  of  the  hand  of  a 
milker  with  Cow  Pox,  to  London,  and  showed  it  to 
Sir  Everard  Home  and  others.  The  subject  of  Cow 
Pox  now  became  a  topic  of  conversation  in  the 
profession,  and  was  mentioned  to  students  by  more 
than  one  lecturer.  Seven  years  after  the  incident  of 
1787  he   wrote  : — 

"  Our  friend  ,  at  our  last  meeting,  treated  my  dis- 
cover}^ as  Chimerical.  Farther  investigation  has  convinced 
me  of  the  truth  of  my  assertion,  beyond  the  possibility  of  a 
denial.  Domestication  of  animals  has  certainly  proved  a  prolific 
source  of  disease  among  men.  But  I  must  not  anticipate  ;  you 
shall   have   a  paper." 

Jenner  had  always  freely  conversed  with  others  on 
this  subject,  and  in  the  same  year  his  intimate  friend 
Dr.  Worthington  gave  an  account  of  his  work  (with- 
out mentioning  his  name)  to  Dr.  Haygarth,  who  in 
replying  made  the  following  criticisms  : — 

"  Your  account  of  the  Cow  Pox  is  indeed  very  marvellous  : 
being  so  strange  a  history,  and  so  contradictory  to  all  past 
observations  on  this  subject,  very  clear  and  full  evidence  will 
be   required   to   render  it   credible. 

"  You  say  that  this  whole  rare  phenomenon  is  soon  to  be 
published ;  but  do  not  mention  whether  by  yourself  or  some 
other  medical  friend.  In  either  case,  I  trust  that  no  reliance 
will  be  placed  upon  vulgar  stories. 

"The  author  should  admit  nothing  but  what  he  has  proved 
by  his  own  personal  observation,  both  in  the  brute  and  human 
species.  It  would  be  useless  to  specify  the  doubts  which 
must  be  satisfied  upon  this  subject,  before  rational  belief  can 
be  obtained. 


134  EDWARD  JENNER. 


"  If  a  physician  should  adopt  such  a  doctrine,  and,  much 
more,  if  he  should  publish  it  upon  inadequate  evidence,  his 
character  would  materially  suffer  in  the  public  opinion  of  his 
knowledge  and  discernment." 

The  subject  of  Cow  Pox  was  not  only  mentioned 
in  conversation  and  lectures  in  London,  but  was 
referred   to   in   medical   works. 

Dr.  Adams,  in  his  work  on  Morbid  Poisons,  pub- 
lished in   1795,  says: — 

"  The  Cow  Pox  is  a  disease  well-known  to  the  dairy-farmers 
in  Gloucestershire.  The  only  appearance  on  the  animal  is  a 
phagedaenic  ulcer  on  the  teat,  without  any  apparent  inflammation. 
When  communicated  to  the  human,  it  produces,  besides  ulceration 
in  the  hand,  a  considerable  tumour  of  the  arm,  with  symptomatic 
fever,  both  which  gradually  subside.  What  is  still  more  extra- 
ordinary, as  far  as  facts  have  hitherto  been  ascertained,  the 
person  who  has  been  infected  is  rendered  insensible  to  the 
\ariolous  poison." 

In  the  second  edition  of  this  work,  published  in 
1807,   in   a   footnote   he  adds: — 

"  Though  this  description  of  Cow  Pox  is  incorrect,  excepting 
in  its  consequence  on  the  human,  I  have  preserved  it  as  an 
historical  register  of  my  imperfect  knowledge  of  this  disease 
when  the  first  edition  was  published.  There  was  then  no 
printed  account  of  the  Cow  Pox.  Mr.  Cline,  knowing  the 
object  of  my  enquiries,  acquainted  me  with  what  he  had  heard 
from  Dr.  Jenner,  and  by  his  correspondence  procured  me 
further  information." 

From  this  it  would  appear  that  Adams  had  indepen- 
dently   commenced     inquiries,    though,    in    a    letter     to 


LIFE  AND  LETTERS. 


'35 


Jenner,   Cline  thought  that  he  was  entirely  responsible 
for  Dr.   Adams'  information  on  the  subject. 

"  I  am  very  glad  to  learn  that  you  are  prosecuting  your 
inquiries  on  the  Cow  Pox,  for  it  is  a  most  interesting  and 
curious  subject.  All  that  Adams  had  heard  of  the  disease  was 
from  me." 

The  same  year  as  Adams'  first  publication,  Dr. 
Beddoes^  wrote  as  follows  : — 

"  I  have  learned  from  my  own  observation,  and  the  testimony 
of  some  old  practitioners,  that  susceptibility  to  the  Small  Pox 
is  destroyed  by  the  Cow  Pox,  a  disease  from  cows,  which  is  a 
malady  more  unpleasant  than  dangerous." 

And  the  year  following,  1 796,  Dr.  Woodville 
referred  to  the  same  subject,  in  a  footnote  in  his 
History  of  Small  Pox  Inoatlation. 

"  It  has  been  conjectured  that  the  Small  Pox  might  have 
been  derived  from  some  disease  of  brute  animals  ;  and  if  it  be 
true  that  the  mange  affecting  dogs  can  communicate  a  species 
of  itch  to  man,  or  that  a  person  having  received  a  certain 
disorder  from  handling  the  teats  of  cows,  is  thereby  rendered 
insensible  to  variolous  infection  ever  afterwards,  as  some 
have  asserted,   then   indeed    this    conjecture   is  not    improbable." 

Jenner  had  not  only  heard  of  cases  of  immunity 
from  Small  Pox  after  Cow  Pox,  but  he  had  made 
notes  of  a  few  which  had  been  brought  to  his  notice. 
In  1778,  he  inoculated  a  Mrs.  H.  unsuccessfully,  which 
result    he     attributed     to    her     having    had     Cow     Pox 

'  Dr.   Beddoes,    Queries  C()7tcer)iing  Inoculation,  8vo.     i795- 


136  EDWARD  JENNER. 


when  very  young.  Simon  Nichols  had  Cow  Pox  in 
1782,  and  "some  years  afterwards"  inoculation  failed, 
and  in  1795,  Jenner  failed  to  inoculate  Joseph  Merret, 
who   had  had  Cow   Pox  in    1770. 

In  1796,  an  opportunity  occurred  for  an  experiment 
of  a  different  kind.  Cow  Pox  occurred  at  a  farm  near 
Berkeley,  in  May,  and  a  dairymaid,  Sarah  Nelmes, 
caught  the  disease.  On  May  14th,  matter  was  taken 
from  a  sore  on  her  hand  and  inserted  by  means  of  two 
superficial  incisions  (as  in  the  method  of  performing 
Small  Pox  inoculation)  into  the  arm  of  James  Phipps, 
a  healthy  boy  about  eight  years  old.  The  inocula- 
tion succeeded,  the  result  being  described  as  much 
the  same  as  after  inoculation  in  the  same  way  with 
variolous  matter,  except  that  the  usual  efflorescence 
had  more  "of  an  erysipelatous  look."  The  whole 
died  away,  leaving  "  scabs  and  subsequent  eschars." 
Jenner  was  so  impatient  to  try  the  effect  of  variolous 
inoculation,  that  on  July  ist,  only  six  weeks  after 
the  insertion  of  the  Cow  Pox  matter,  variolous  lymph 
was  applied,  by  means  of  punctures  and  slight  incisions. 
Jenner  communicated  his  experiments  on  Phipps  to 
his  friend  Gardner. 

"  Dear  Gardner, 

"  As  I  promised  to  let  you  know  how  I  proceeded  in  my 
inquiry  into  the  nature  of  that  singular  disease  the  Cow  Pox, 
and  being  fully  satisfied  how  much  you  feel  interested  in  its 
success,  you  will  be  gratified  in  hearing  that  I  have  at  length 
accomplished  what  1  have  been  so  long  waiting  for,  the  passing  of 


■Fiiri/ig  j<a^e  136. 
PLATE  II. 


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LIFE  AXD  LETTERS.  137 

the    Vaccine  Virus   from    one    human   being   to    another    by    the 
ordinary  mode  of  inoculation. 

"  A  boy  of  the  name  of  Phipps  was  inoculated  in  the  arm  from 
a  pustule  on  the  hand  of  a  young  woman  who  was  infected  by 
her  master's  cows.  Having  never  seen  the  disease  but  in  its 
casual  way  before,  that  is,  when  communicated  from  the  cow 
to  the  hand  of  the  milker,  I  was  astonished  at  the  close  resem- 
blance of  the  pustules,  in  some  of  their  stages,  to  the  variolous 
pustules.  But  now  listen  to  the  most  delightful  part  of  my  story. 
The  boy  has  since  been  inoculated  for  the  Small  Pox  which,  as  I 
ventured  to  predict,  produced  no  effect.  I  shall  now  pursue 
my  experiments   with   redoubled   ardour. 

''  Believe  me  yours,  very  sincerely, 

"  Edward  Jenner. 
"Berkeley,  Jtily  19,   1796." 

Jenner  had  now  materials  for  another  paper  for  the 
Royal  Society,  but  he  waited  a  year  in  order  to 
add  two  or  three  more  cases,  of  failure  to  inoculate 
after  casual  Cow  Pox.  In  February  1797,  William 
Rod  way's  case  was  added,  and  a  month  later  the 
cases    of   Sarah    and    Elizabeth    Wynne. 

Jenner  lost  no  time  in  finishing  his  paper,  but  he 
little  anticipated  the  reception  it  was  destined  to  meet 
with.      Baron  says  : — 

"It  was  his  intention  that  it  should  first  have  appeared 
before  the  public  in  the  Transactions  of  the  Royal  Society,  but  this 
design  was  abandoned,  and  the  work  appeared  as  a  separate 
publication." 

Baron  does  not  say  here,  why  the  idea  was  aban- 
doned, and  Janies  Moore  was  the  first  to  publish 
what    actually   took    place.       In    1796    or    1797,  Jenner 


138  EDWARD  JENNER. 


transmitted  his  manuscript  to  a  correspondent,  who 
was  in  the  confidence  of  Sir  Joseph  Banks,  President 
of  the  Royal  Society,  not  doubting  that  it  would 
be  printed  in  the  Transactions  of  the  Royal  Society. 
The  perusal  of  his  cases  and  experiments  produced 
no  conviction  whatever,  and  he  received  a  friendly 
admonition  in  reply,  that  as  he  had  gained  some  repu- 
tation by  his  former  papers  to  the  Royal  Society, 
it  was  advisable  not  to  present  this  one,  which  would 
injure  his  established  credit.  In  the  second  volume 
of  the  Biography,  published  in  1837,  Baron,  no 
longer,  suppressed  the  details  in  connection  with 
this  incident,  but  published  a  letter  of  Jenner's,  in 
which  a  reference  is  made  to  the  rejection  of  the 
paper : — 

"  I  explained  in  conversation,  as  I  said  before,  all  that  passed 
respecting  my  first  paper  on  the  Cow  Pox  intended  for  the  Royal 
Society.  It  was  not  with  Sir  Joseph,  but  with  Home  ;  he  took 
the  paper.  It  was  shewn  to  the  Council,  and  returned  to  me. 
This,  I  think,  was  in  the  year  1797,  after  the  vaccination  of  one 
patient  only  ;  but  even  this  was  strong  evidence,  as  it  followed 
that  of  the  numbers  I  had  put  to  the  test  of  the  Small  Pox 
after  casual  vaccination." 

After  making  a  few  additional  experiments,  Jenner 
resolved  to  publish  the  paper  himself  In  June,  1797, 
he  wrote  : — 

"  1  have  shown  a  copy  of  my  intended  paper  on  the  Cow 
Fox  to  our  friend,  Worthington,  who  has  been  pleased  to  express 
his  approbation  of  it,  and  to  recommend  my  publishing  it  as  a 
l)aniphlet,    instead    of  sending   it   to   the   Royal   Society." 


LIFE  AND  LETTERS. 


139 


His  friends,  Gardner  and  Hicks,  were  often  con- 
sulted about  it,  and  it  was  shown  to  and  scrutinised 
by  a  number  of  his  particular  associates.  It  was 
also  submitted  to  Woodville,  who  endeavoured  to 
persuade  Jenner  to  leave  out  his  speculations  with 
regard  to  the  origin  of  Cow  Pox  from  "the  grease;" 
but  Jenner  wc^uld  not  hear  of  it.  The  Inquiry  was 
published  about  the  end  of  June,  1798,  Jenner  having 
left  Berkeley  for  London  to  see  the  printers  on  the 
24th  of  April,  and  returned  home  on  the  14th  of  July, 
While  in  London,  Jenner  had  another  opportunity  ot 
speaking  about  this  subject  to  his  professional  brethren, 
but  he  was  unable,  durino;  the  whole  time  that  he  was 
in  the  metropolis,  to  procure  a  single  person  on  whom 
he  could  exhibit  the  results  of  inoculation.  Some  of 
the  virus,  however,  which  he  carried  with  him  was 
presented  to  Mr.  Cline,  who,  at  the  end  of  July, 
inserted  it  into  the  hip  of  a  patient  by  two  punctures. 
This  patient  had  some  affection  of  the  hip  joint,  and 
it  was  thought  that  the  counter-irritation,  excited  by 
the  Cow  Pox,  might  prove  beneficial,  and  it  was 
intended  to  convert  the  ulcer,  which  was  anticipated, 
into  an  issue.  This  operation  is  referred  to  in  the 
following  extract  from   Jenner  s  Journal  : — 

Extracts  from  Journal  ot    1798. 

"That  the  matter  of  Cow  Pox,  like  the  Small  Pox  matter,  may 
be  preserved  without  any  diminution  in  its  active  qualities  is 
evinced  by  the   following  experiment. 


140  EDWARD  JENNER. 


"  Mr.  Cline  inoculated  a  child  with  matter  that  had  been  taken 
from  the  pustule  on  the  arm  of  Hannah  Excell  (see  page  39 
pamphlet)  when  in  a  limpid  ichorous  state,  and  dried  by  exposure 
to  the  air,  after  being  preserved  three  months  on  a  quill  in  a 
seal.     The  following  is  the  result : — 

"  Copy  of  Mr.  Clink's  Letter. 

"  Lincoln's-Inn  Fields,  2d  Aug.  1798. 
"The  Cow  Pox  experiment  has  succeeded  admirably.  The 
child  sickened  on  the  seventh  day  ;  and  the  fever,  which  was 
moderate,  subsided  on  the  eleventn  da}'.  The  inflammation 
extended  to  about  four  inches  diameter,  and  then  gradually  sub- 
sided without  having  been  attended  with  pain,  or  other  incon- 
venience. The  ulcer  was  not  large  enough  to  contain  a  pea, 
therefore,  I  have  not  converted  it  into  an  issue  as  I  intended.^ 
I  have  since  inoculated  him  with  Small  Pox  matter  in  three 
places,  which  were  slightly  inflamed  on  the  third  day,  and  then 
subsided. 

"  Dr.  Lister,  who  was  formerly  physician  to  the  Small  Pox 
Hospital,  attended  the  child  with  me,  and  he  is  convinced  that 
it  is  not   possible  to  give  him   the  Small  Pox. 

"  1  think  the  substituting  of  Cow  Pox  poison  for  the  Small 
Pox  promises  to  be  one  of  the  greatest  improvements  that  has 
ever  been  made  in  medicine  :  for  it  is  not  only  so  safe  in  itself,  but 
also  does  not  endanger  others  by  contagion,  in  which  way  the 
Small  Pox  has  done  infinite  mischief.  The  more  I  think  on 
the  subject,  the  more  I  am  impressed  with  its  importance. 
"  With  great  esteem  I  am,  dear  Sir, 

"  Your  faithful  servant, 

"  Henry  Cline." 

"  With  the  intention  of  proceeding  with  the  experiments,  Mr. 
Cline  took  matter  from  the  pustule,  and  with  it  inoculated  three 
other  children  ;  but  on  none  of  these  did  it  take  any  effect." 

'  This  boy  was  brought  to  town  on  account  of  some  disease  in  the  joint 
of  the  hip.  Mr.  C.  therefore  inoculated  near  the  part,  with  the  view  of 
exciting  inflammation,  and  subsequently  of  forming  an  issue. — E.  J.  [See 
vol.  ii.,  p.  184.] 


LIFE  AND  LE7TERS.  141 


"  I  have  observed  that  the  matter  of  Cow  Pox  appears  to  lose 
its  powers  of  infection  after  it  ceases  to  be  limpid.  Probably  it 
might  have  passed  the  bounds  of  perfection  when  Mr.  Cline  made 
his  second  experiment." 

"  Henry  Cline,   Esq.,  to  Dr.  Jenner. 

"  Lincoln's-Inn  Fields,  i?,th  Augitsf,  1798. 
"  Mv  Dear  Sir, — Seven  da3's  since,  I  inoculated  three  children 
with  Cow  Pox  matter,  and  I  have  the  mortification  of  finding  that 
the  infection  has  not  taken,  and  I  fear  1  shall  be  entirely  dis- 
appointed unless  you  can  contrive  to  send  me  some  fresh  matter. 
I  think  it  might  come  in  a  quill  in  a  letter,  or  inclosed  in  a  bit  of 
tin-foil,  by  the  same  conveyance,  or  in  any  other  way  that  may  be 
more  convenient. 

"With  much  esteem,  I  am,  dear  Sir, 

"  Your  faithful  servant, 

"  Henry  Cline." 

Mr.  Cline  having  failed  to  carry  on  the  disease  from 
the  first  case  of  vaccination  in  London,  and  Jenner 
also  having  failed  in  the  country,  the  stock  of 
lymph  vi^as  lost,  and  the  latter  was  therefore  unable 
to  supply  those  who  were  anxious  to  try  the  new 
inoculation,  and  to  test  its  alleged  prophylactic  powers. 

According-  to  Baron,  Mr.  Cline  was  more  than 
satisfied  with   the   result  of  his   experiment. 

"  Mr.  Cline,  perceiving  at  once  from  the  success  of  his  first  trial 
what  incalculable  blessings  were  connected  with  the  diffusion  oi 
the  practice,  with  just  a  becoming  regard  for  the  welfare  of  Jenner, 
wished  his  personal  advantage  to  keep  pace  in  some  degree  witli 
the  benefits  which  he  had  it  in  his  power  to  impart  to  mankind. 
He,  therefore,  immediately  advised  him  to  quit  the  country,  and  to 
take  a  house  in  Grosvenor  Square,  and  promised  him  ^10, 000  per 
annum  as  the  result  of  his  practice." 


J 42  EDWARD  JENNER. 


Another  friend  endeavoured  to  persuade  him  to  seize 
this  as  an  opportunity  of  acquiring  fame  and  fortune. 
But  Jenner  declined,  and  in  a  letter  in  answer  to 
his  friend  the  reason  is  made  apparent.  Jenner  pre- 
ferred retirement  in  the  country,  because  he  knew 
that  his  theory  would  be  rigidly  tested  in  London, 
and  he  was  not  prepared  to  face  failures.  At  this 
early  stage,  he  was  evidently  conscious  of  the  fact 
that  the  variolous  test  would  break  down,  as  he  was 
already  prepared  with  an  answer  to  meet  the  results 
he  anticipated. 

"  Cheltenham,  September  29^/2. 

"  It  is  very  clear  from  your  representation  that  there  is  now 
an  opening  in  town  for  any  physician  whose  reputation  stood  fair 
in  the  public  eye.      But  here,  my  dear  friend,  here  is  the  rub.  .  .  . 

"  How  very  few  are  capable  of  conducting  physiological  experi- 
ments !  I  am  fearful  that  before  we  thoroughly  understand  what 
is  Cow  Pox  matter,  and  what  is  not,  some  confusion  may  arise,  for 
which  I  shall  unjustly  be  made  answerable.  In  the  first  place, 
instances  will  occur  where  those  who  have  truly  had  the  disease 
shall  be  subjected  to  the  common  process  of  inoculation,  inflamma- 
tion, vesication,  and  even  pus  will  appear  on  the  wounded  part. 
The  axilla  will  show  that  the  lymphatics  have  been  active,  and  the 
system  may  even,  in  a  very  limited  degree,  feel  the  consequence. 
What  would  the  enemies  to  the  improvement  of  science  say  to 
this  ?  I  leave  you  to  answer  this  question.  But  the  very  same 
thing  has  happened  again  and  again  to  those  who  have  had  the 
Small  Pox  ;  and  do  not  those  (nurses  for  example)  who  are  much 
exposed  to  the  contagion  of  Small  Pox  ?  "  .   .  . 

[The  rest  of  this  letter  is  unfortunately  lost.] 


P)Ut 


in    the    .seclusion   of  his    country    home,    Jenner 


LIFE  AND  LETTERS.  143 

was  able  to  ponder  over  unfavourable  criticisms,  and 
exercise  his  ingenuity  in  finding  explanations.  It  was 
not  long  before  the  anticipated  opposition  had  to  be 
encountered. 

Dr.  Ingenhousz,  a  distinguished  physician  and  man  of 
science,  was  on  a  visit  to  the  Marquis  of  Lansdowne, 
at  his  seat  in  Wiltshire. 

Ingenhousz  had  made  a  special  study  of  Small  Pox, 
and  having  read  Jenner's  publication,  at  once  instituted 
inquiries  among  the  dairies  in  Wiltshire. 

His  experience  was  communicated  to  Jenner  in  a 
letter  wTitten  from  Bowood  Park,  October  12th, 
1798:- 

Dr.   Ingenhousz  to  Dr.  Jenner. 

"Sir, —  Having  read  with  attention  your  performance  on  the 
Variolae  Vaccinae,  and  being  informed  by  everyone  who  knows 
you  that  you  enjoy  a  high  and  well-deserved  reputation  as  a  man 
of  great  learning  in  your  profession,  you  cannot  take  it  amiss  if  I 
take  the  liberty  to  communicate  to  you  a  fact  well  deserving  your 
attention,  and  with  which  you  ought  to  be  made  acquainted.  I 
prefer  this  private  method  of  conveying  ray  information  to  any 
other  which  might  expose  you  to  the  disagreeable  necessity  of 
entering  into  a  public  controversy,  always  disagreeable  to  a  man 
so  liberal-minded  and  well-intentioned  as  your  treatise  indicates 
you  to  be. 

"  As  soon  as  I  arrived  at  the  seat  of  the  Marquess  of  Lansdowne, 
Bowood,  near  Calne,  I  thought  it  my  duty  to  inquire  concerning 
the  extraordinary  doctrine  contained  in  your  publication,  as  1  knew 
the  Cow  Pox  was  well  known  in  this  country.  The  first  gentle- 
man to  whom  I  addressed  myself  was  Mr.  Alsop,  an  eminent 
practitioner  at  Calne.  This  gentleman  made  me  acquainted  with 
Mr.   Henry  Stiles,  a  respectable  farmer  at  Whitley,   near  Calne, 


144  EDWARD  JENNER. 


who,  thirty  years  ago,  bought  a  cow  at  a  fair,  which  he  found  to 
be  infected  with  what  he  called  the  Cow  Pox.  This  cow  soon 
infected  the  whole  dairy  ;  and  he  himself,  by  milking  the  infected 
cow,  caught  the  disease  which  you  describe,  and  that  in  a  very 
severe  way,  accompanied  with  pain,  stiffness,  and  swelling  in  the 
axillary  glands.  Being  recovered  from  the  disease,  and  all  the 
sores  dried,  he  was  inoculated  for  the  Small  Pox  by  Mr.  Alsop. 
The  disease  took  place  :  a  great  many  Small  Pocks  came  out  ,and 
he  communicated  the  infection  to  his  father,  who  died  of  it.  This 
being  an  incontrovertible  fact,  of  which  I  obtained  the  knowledge 
from  the  very  first  man  to  whom  I  addressed  myself,  cannot  fail 
to  make  some  impression  on  your  mind,  and  excite  you  to  inquire 
farther  on  the  subject,  before  you  venture  finally  to  decide  in 
favour  of  a  doctrine,  which  may  do  great  mischief  should  it 
prove  erroneous."  .  .   . 

Dr.  Jenner  to  Dr.  Ingenhousz. 

"  Dear  Sir, — I  shall  ever  consider  myself  as  under  great 
obligations  to  you,  for  the  very  liberal  manner  in  which  you  have 
communicated  a  fact  to  me  on  a  subject  in  which  at  present  I  feel 
myself  deeply  interested ;  a  subject  of  so  momentous  a  nature 
that  I  am  happy  to  find  it  has  attracted  the  attention  of  some  of 
the  first  medical  philosophers  of  the  present  age,  among  whom  it 
is  no  compliment  in  me  to  say  that  I  have  long  classed  you. 

"  It  will  doubtless,  in  the  course  of  time,  meet  with  a  full  investi- 
gation ;  but  as  that  moves  on  (and  from  the  nature  of  the  inquiry 
it  must  move  slowly)  I  plainly  foresee  that  many  doubts  will  arise 
respecting  the  validity  of  my  assertion,  from  causes  which  ought 
to  be  examined  with  the  nicest  inspection  before  their  convictive 
force  be  fully  admitted. 

"Truth,  believe  me.  Sir,  in  this  and  every  other  physiological 
investigation  which  has  occupied  my  attention,  has  ever  been  the 
object  which  I  have  endeavoured  to  hold  in  view.  In  the  publi- 
cation on  the  Variolse  Vaccinae,  I  have  given  little  more  than  a 
simple  detail  of  facts  which  came  under  my  own  inspection,  and  to 
the  public  I  stand  pledged  for  its  veracity.  In  the  course  of  the 
inquiry,  which  occupied  no  inconsiderable  portion  of  my  time  and 
attention,  not  a  single  instance  occurred  of  a  person's  having  the 


LIFE  AND  LETTERS. 


145 


disease,  either  casually  or  from  inoculation,  who  on  subsequent 
exposure  to  variolous  contagion  received  the  infection  of  the 
Small  Pox,  unless  that  inserted  in  page  71^  may  be  admitted  as  an 
exception.  And  from  the  information  you  have  given  me,  and 
from  what  I  have  obtained  from  others  who  have  perused  the 
jiamphlet,  I  am  induced  to  suppose  that  my  conjecture  respecting 
the  cause  of  that  patient's  insecurity,  namely,  her  having  had  the 
disease  without  any  apparent  affection  of  the  system,  might  have 
been  erroneous ;  and  that  the  consequences  might  be  more 
lairly  attributable  to  a  cause  on  which  I  shall,  in  my  present 
address  to  you,  feel  it  my  duty  to  speak  explicitly.  Should  it 
appear  in  the  present  instance  that  I  have  been  led  into  error, 
fond  as  I  may  appear  of  the  offspring  of  my  labours,  I  had  rather 
strangle  it  at  once  than  suffer  it  to  exist,  and  do  a  public  injury. 
At  present,  I  have  not  the  most  distant  doubt  that  any  person 
who  has  once  felt  the  influence  of  perfect  Cow  Pox  matter,  would 
ever  be  susceptible  of  that  of  the  Small  Pox.  But  on  the  contrary, 
1  perceive  that  after  a  disease  has  been  excited  by  the  matter  of 
Cow  Pox  in  an  imperfect  state,  the  specific  change  of  the  con- 
stitution necessary  to  render  the  contagion  of  the  Small  Pox  inert 
is  not  produced,  and  in  this  point  of  view,  as  in  most  others, 
there  is  a  close  analogy  between  the  propagation  of  the  Cow  Pox 
and  the  Small  Pox.  Therefore,  I  conceive  it  would  be  prudent, 
until  further  inquiry  has  thrown  every  light  on  the  subject  which 
it  is  capable  of  receiving,  that  (like  those  who  were  the  objects  of 
my  experiments)  all  should  be  subjected  to  the  test  of  variolous 
matter  who  have  been  inoculated  for  the  Cow  Pox." 

When  discussing  the  subject  of  Cow  Pox  with 
neighbouring  practitioners,  Jenner  had  previously  been 
confronted  with  the  statement  that  there  were  un- 
doubted instances  of  Small  Pox  occurring  after  Cow 
Pox,  and  he  had  met  this  argument  by  the  assertion 
that  there  were  two  kinds  of  Cow  Pox  ;  and  those 
cases  which  had  been  subsequently  variolated  must  have 

'  Vol.  ii.,  p.  32. 
VOL.    I.  10 


146  EDWARD  JENNER. 


had  "false"  Cow  Pox,  while  those  which  had  not 
been  variolated  had  had  "true"  Cow  Pox.  Ingenhousz 
had  independently  brought  forward  the  argument  of  the 
neighbouring  practitioners,  and  this  led  Jenner  to  realise 
still  more  the  weak  point  of  his  case.  He  keenly  felt 
the  necessity  for  disseminating,  far  and  wide,  the 
doctrine  of  spurious  Cow  Pox,  which  would  cut  away 
the  ground  from  under  the  feet  of  a  host  of  objectors. 
In  this  cause,  he  enlisted  the  assistance  of  his  friend 
Gardner. 

Dr.  Jenner  to  Mr.  Edward  Gardner. 

"  Dear  Gardner, — I  fully  depend  upon  meeting  you  at  Easting - 
ton  to-morrow  to  sit  in  council  on  several  subjects  of  high  import. 
M}'  friends  must  not  desert  me  now.  Brickbats  and  hostile  wea- 
pons of  every  sort  are  flying  thick  around  me  ;  but  with  a  very 
little  aid,  a  few  friendly  opiates  seasonably  administered,  they 
will    do    me   no  injury. 

"  Ingenhousz  has  declined  my  offer  of  receiving  my  letter  in 
print — so  that  must  be  modelled  anew.  We  must  set  off  by 
impressing  the  idea  that  there  will  be  no  end  to  cavil  and  contro- 
versy until  it  be  defined  with  precision  what  is,  and  what  is  not 
Cow  Pox. 

"  The  true  has  many  imitations  by  \\\^  false  on  the  cow's  udder 
and  nipples ;  and  all  is  called  Coiv  Pox,  whether  on  the  cow  or 
communicated  to  the  human  animal. 

"  My  experiments  move  on — but  I  have  all  to  do  single-handed. 
Not  the  least  assistance  from  a  quarter  where  I  had  the  most  right 
to  expect  it !  ! 

"Bodily  labour  I  disregard,  but  pressures  of  the  mind  grow  too 
heavy  for  me.  Added  to  all  my  other  cares,  I  am  touched  hard 
with  the  reigning  epidemic — Impecuniosity. — Any  supplies  from 
the  paper-maker  ?  "  Adieu  ! 

"  Your  faithful  friend, 

'*  Wednesday  Jiioniiiig."  "  E.  J. 


LIFE  AND  LETTERS.  147 

Jenner  recognised  a  formidable  antagonist  in  Ingen- 
housz,  whose  opposition  bid  fair  to  wreck  his  theory. 
He  therefore  deputed  Mr.  Paytherus,  who  was  well 
trained  in  the  cause  of  Cow  Pox  inoculation,  to  endea- 
vour to  gain  over  the  enemy  by  personal  explanations. 
Mr.   Paytherus,  however,  entirely  failed  in  his   mission. 

T.    Paytherus,   Esy.,  to  Dr.  Jenner. 

^^  December  i/^th,  1798. 
"  Dear  Jenner, — The  moment  I  received  your  letter  I  called  on 
Ingenhousz  ;  he  was  in  the  country,  but  expected  in  town  the  next 
day.  Yesterday  I  called  a  second  time,  and  made  an  appointment 
for  this  morning,  in  consequence  of  which  1  have  had  an  interview 
with  this  very  interesting  character. 

"  A  more  determined  or  a  more  formidable  opponent  you  need 
not  covet  or  desire.  Unfortunately  for  your  hypothesis,  he  made 
his  first  inquiry  of  a  Mr.  Alsop,  of  Calne,  who  immediately  named 
a  person  who  had  had  the  Small  Pox  after  the  Cow  Pox.  This 
person  he  was  afterwards  introduced  to,  and  satisfied  himself  of 
the/r7c/.  The  second  application  was  to  Major-General  Hastings  : 
he  also  pointed  out  an  instance  of  the  Small  Pox  subsequent  to 
the  Cow  Pox  at  Adlestrop. 

"  Dr.  Garthshore  has  also  at  Dr.  Ingenhousz's  request  written 
to  Dr.  Pulteney,  of  Blandford,  who  in  reply  has  assured  him  that 
the  inoculators  of  his  neighbourhood  have  known  many  instances 
of  the  Small  Pox  happening  after  the  Cow  Pox.  He  believes  that 
it  does  in  many  instances  produce  that  change  in  the  human  con- 
stitution as  to  render  it  unsusceptible  of  the  Small  Pox,  but  not 
with  certainty  in  all  cases.  He  would  not  hear  a  word  in  defence 
of  your  opinion  respecting  its  origin. 

"  He  is  confident  that  a  spurious  Small  Pox  cannot  be  produced 
by  what  you  call  putrescent  variolous  matter,  and  that  whether 
the  matter  be  kept  in  a  wet  sponge,  or  on  cotton,  either  in  a  moist 
or  a  dry  state,  it  will  uniformly  produce  the  Small  Pox.  Yet  he 
confessed  in  his  own  practice  that  the  dried  matter  more  generally 
produced  a  confluent  Small   Pox.      In  your  last  letter  to  him  you 


EDWARD  JENNER. 


speak  of  the  putrescent  state  of  the  Cow  Pox  matter,  and  that 
the  milk  might  Hkewise  undergo  a  similar  change.  To  this  he 
objects,  and  says  that  milk  will  become  acescent,  not  putrescent. 

"  That  it  should  render  the  habit  unsusceptible  of  Small  Pox, 
and  not  of  its  own  specific  action,  is  to  him  incredible.  You  tell 
him  in  one  of  your  letters  that  you  have  heard  from  Adlestrop, 
and  that  the  father  of  the  boy  or  girl  now  thinks  that  the  Small 
Pox  preceded  the  Cow  Pox.  To  think,  it  seems,  is  to  doubt,  and 
he  says  the  ambiguity  on  the  part  of  the  father  confirms  the  first 
statement  instead  of  weakening  it.  His  respect  for  your  character 
has  kept  him  from  publishing,  and  he  declines  entering  into  con- 
troversy with  you.  Had  you  been  a  less  formidable  antagonist 
he  would  have  flogged  you  long  since.  He  spoke  very  hand- 
somely of  you,  and  desired  me  to  assure  you  that  nothing  would 
have  kept  him  from  answering  your  letters  but  the  desire  of 
satisfying  his  mind  on  the  subject.  He  desires  that  you  will  not 
be  in  haste  to  publish  a  second  time  on  the  Cow  Pox,  but  wait  till 
you  have  collected  a  sufficient  number  of  facts,  and  to  secure  your 
ground  as  you  advance.  He  remarked  that  you  would  not  be  per- 
mitted to  be  judge  in  your  own  cause  ;  that  you  were  now  before 
the  tribunal  of  the  public,  and  so  long  as  sub  judice  lis  est,  you 
ought  not  to  risk  an  opinion." 

******* 

Jenner  keenly  felt  the  antagonism  of  Ingenhousz, 
and  was  at  a  loss  to  know  what  to  do.  Again  he 
writes   to  Gardner  for  sympathy  and  advice. 

Dr.  Jenner  to  Mr.  Edward  Gardner. 

"  Berkeley. 
"  Dear  Gardner, — We  wondered  at  Ingenhousz's  delay  in 
answering  my  letters,  particularly  the  long  one  that  you  inspected. 
A  tempest  is  generally  preceded  by  a  calm.  He  has  in  some 
measure  exemplified  the  remark,  I  know  not  what  to  do  with 
him,  and  wish  for  your  advice,  after  you  have  seen  his  letter.  It 
is  a  matter  of  real  moment — a  matter  on  which,  perhaps,  much  of 
my  future  peace  may  rest — indeed,  my  existence.      I    sometimes 


LIFE  AND  LETTERS.  149 


think  that  it  would  be  most  prudent  to  desire  him  to  make  public 
all  he  knows  of  the  Cow  Pox  ;  but  would  there  not  in  this  measure 
be  a  sort  of  defiance  that  might  irritate  ?  The  grand  question  to 
1)6  determined  at  present  is  this  :  Shall  I  immediately  publish  an 
appendix,  or  say  nothing  till  every  bolt  is  flung,  and  then  attack 
my  adversaries  ? 

"This  very  man  Ingenhousz  knows  no  more  of  the  real  nature 
of  the  Cow  Pox  than  Master  Sehvyn  does  of  Greek.  Yet  he  is 
among  philosophers  what  Johnson  was  among  the  literati,  and,  by 
the  way,  not  unlike  him  in  figure;  'tis  no  use  to  shoot  straws  at  an 
eagle.     When  shall  I  see  you  ? 

"Yours  sincerely, 

"E.  J." 

After  his  return  from  London,  in  July  1798,  Jenner 
spent  most  of  his  time  until  the  following  February  at 
Cheltenham  and   Berkeley. 

He  had  lost  his  stock  of  lymph,  and  now 
had  encountered  an  antagonist  on  whose  opposition 
depended  not  only  his  future  peace,  but  his  very  ex- 
istence. Such  was  the  state  of  the  Cow  Pox  question 
at  that  period,  and  Jenner  might  well  have  felt  in 
despair  ;  but  the  fate  of  the  new  inoculation  was  not 
destined  to  be  consigned  to  oblivion,  for  the  much- 
needed  help  came  from  a  very  unexpected  quarter. 

The  subject  had  been  receiving  increased  attention 
from  men  of  science  in  London.  Some  were  anxious 
to  obtain  further  information,  others  questioned  the 
accuracy  of  Jenner's  statements,  and  treated  his  doc- 
trines as  "  conjectural  and  ridiculous."  Among  the 
former  were  Dr.  George  Pearson  and  Dr.  Woodville, 
physicians  to  the   Small   Pox   Hospital. 


150  EDWARD  JENNER. 


Dr.  Pearson  set  to  work  with  extraordinary  zeal, 
making  inquiries  by  means  of  correspondence  with 
practitioners  in  all  parts  of  the  country,  and  in  less 
than  six  months  after  the  publication  of  Jenner's  Z^^^^^zry, 
produced  a  volume  in  which  he  incorporated  all  the 
information  which  he  had  received  as  to  the  prevalence 
of  Cow  Pox  and  its  alleged  protective  power,  together 
with  his  own  comments  on  the  proposed  substitute  for 
Small  Pox  inoculation. 

Dr.  Pearson  had  not  been  able  to  make  any  experi- 
ments, as  during  the  few  months  in  which  he  had 
been  making  inquiries,  he  had  not  succeeded  in  meeting 
with  an  outbreak  of  Cow  Pox  ;  but  having  sent  his 
book  to  press,  his  next  wish  was  to  inoculate.  Thus 
he  wrote  to  Jenner,  on   November  8th,  1798  : — 

"  Your  name  will  live  in  the  memory  of  mankind  as  long  as 
men  possess  gratitude  for  services  and  respect  for  benefactors  ; 
and  if  I  can  but  get  matter,  I  am  much  mistaken  if  I  do  not  make 
you  live  for  ever." 

Dr.  Pearson's  book  was  issued  by  the  publishers 
about  the  middle  of  November,  a  fact  which  he 
announced    to    Jenner    in    the    following    letter. 

Dr.  Pearson  to  Dr.  Jenner. 

"  My  Dear  Sir, — Unexpectedly  my  pamphlet  made  its  public 
appearance  a  day  or  two  ago.  I  am  sorry  to  trouble  you  to  say 
by  what  conveyance  I  can  send  you  a  copy,  and  to  what  place.  If 
you  have  any  commissions  to  execute  in  London,  you  may  as  well 
have  a  parcel  made  up,  and  I  will  see  it  forwarded. 

"  I  observe  several  errors  since  printing,  partly  mine  and  partly 


LIFE  AND  LETTERS.  151 


those  of  the  printer;  but  I  know  other  authors  discover  similar 
errors,  and  tliat  readers  do  not  perceive  them. 

"  You  cannot  imagine  how  fastidious  the  people  are  with  regard 
to  this  business  of  the  Cow  Pox.  One  says  it  is  very  filthy  and 
nasty  to  derive  it  from  the  sore  heels  of  horses  !  Another,  *  O  my 
God,  we  shall  introduce  the  diseases  of  animals  among  us,  and  we 
have  too  many  already  of  our  own  !'  A  third  sapient  set  say  it  is 
a  strange  odd  kind  of  business,  and  they  know  not  what  to  think 
of  it  !  All  this  I  hear  very  quietly,  and  recollect  that  a  still  more 
unfavourable  reception  was  experienced  by  the  inoculation  for  the 
Small  Pox. 

"I  wish  you  could  secure  for  me  matter  for  inoculation,  because, 
depend  upon  it,  a  thousand  inaccurate  but  imposing  cases  will  be 
published  against  the  specific  nature  of  the  disease  by  persons  who 
want  to  send  their  names  abroad  about  anything,  and  who  will 
think  yourself  and  me  fair  game.  By  way  of  se  dcfendendo  we 
must  inoculate.  I  have  thought  it  right  to  publish  the  evidence  as 
sent  to  me,  and  also  my  own  reasoning,  because  I  know  you  are 
too  good  a  philosopher  to  be  offended  at  the  investigation  of  truth, 
although  the  conclusions  may  be  different  from  your  own.  1  think, 
too,  your  principal  facts  will  be  the  better  established  than  if  it  had 
happened  that  I  had  uniformly  acceded  to  all  your  doctrine. 

"  1  am,  with   Mrs.  P.'s  best  compliments  to  Mrs.  Jenner 
and  yourself, 

"  Your  faithful  Servant, 

"  G.   Pearson. 

"Leicester  Square,  A^ot'.  13///,  1798." 

According  to  Baron,  a  few  days  afterwards  (Novem- 
ber 26th),  Jenner  succeeded  in  obtaining  Cow  Pox 
virus  from  a  farm  at  Stonehouse,  and  on  the  following 
day,  he  inoculated  two  of  the  children  of  his  friend, 
Mr.  Hicks  of  Eastington.  Baron  relates  this  to 
disprove  an  assertion,  subsequently  made,  that  the 
first     vaccinations     performed      by      Jenner    after     the 


152  EDWARD  JENNER. 

publication   of    the  Inquiry   were    with   lymph    received 
from  Pearson.     This  subject  will  be  referred  to  again  ; 
in     the    meantime    the     history    of    what    occurred     in 
London  will   be   continued. 

Dr.  Woodville,  as  well  as  Dr.  Pearson,  were  very 
curious  to  try  the  new  inoculation  ;  and  after  patiently 
waiting,  their  wish  was  gratified,  for  the  welcome 
news  was  received  that  Cow  Pox  existed  in 
London    dairies. 

In  January  1799,  Mr.  Wachsel  obtained  intelligence 
that  Cow  Pox  had  broken  out  among  the  cows  in 
Gray's  Inn  Lane,  and  reported  it  to  Woodville  ;  and 
at  the  same  time,  Pearson  heard  that  the  disease 
was  raging  among  a  large  herd  of  cows  in  the 
New  Road,  near  Paddington.  With  vaccine  matter 
from  these  sources,  Woodville  experimented  at  the 
Small  Pox  Hospital,  and  Pearson  also  induced  persons 
to  be   inoculated. 

Jenner  received  information  of  the  discovery,  a  few 
days  afterwards,  from  Woodville. 

Dr.  Woodville  to  Dr.  Jenner. 

"  Ely  Place.  Jcdi.  25,  1799. 
"  Dear  Sir, 

******* 

"  On  Sunday  last,  I  was  informed  that  the  Cow  Pox  had  broke 
out  among  Mr.  Harrison's  cows  in  Gray's  Inn  Lane  The 
next  day  I  took  Mr.  Tanner  with  me  to  examine  them ;  and 
as  he  declared  it  to  be  the  genuine  disease,  I  thai  day  inoculated 
six    persons    with    the    matter    that    he    procured    from    a    cow 

'  Vide^.  162. 


LIFE  AND  LETTERS.  153 

which  appeared  to  be  the  most  severely  affected  with  this 
pustular  complaint.  On  Wednesday,  I  called  again  at  the  cow- 
house to  make  farther  inquiries,  when  I  was  very  much  pleased 
to  find  two  or  three  of  the  milkers  were  infected  with  the 
disease,  one  of  whom  exhibited  a  more  beautiful  specimen  of 
the.  disease  than  that  which  you  have  represented  in  the  first 
plate.  From  this  person  I  charged  a  lancet  with  the  matter, 
which  appeared  difterent  from  that  taken  from  the  cow,  as  that 
of  the  former  was  purely  lymphatic,  and  the  latter  of  a  purulent 
form.  With  this  lymphatic  matter  I  immediately  inoculated 
two  men  at  the  hospital. 

"  Finding  now  there  could  be  no  doubt  of  the  disease,  I  the 
same  day  called  upon  Sir  Joseph  Banks,  Dr.  Pearson,  Dr. 
Willan,  etc.,  to  inform  them  of  the  circumstance ;  and  these 
gentlemen,  together  with  Lord  Somerville,  Sir  William  Watson, 
and  Mr.  Coleman,  met  me  the  following  day  at  the  cow-keeper's, 
where  your  book  was  produced  ;  and  upon  comparing  your 
figure  with  the  disease  it  was  allowed  by  all  to  be  a  very 
faithful  representation,  and  every  gentleman  seemed  highly 
gratified  at  seeing  so  good  an  example  of  the  Cow  Pox.  From 
this  place  we  proceeded  to  the  hospital,  where  I  inoculated  six 
patients,  so  that  the  whole  number  inoculated  by  me  with  the 
Cow   Pox  matter  amounts  to  fourteen." 

******* 

Jenner  was  quite   satisfied  from   this  description  that 

Woodville    had     discovered     "  true  "     Cow     Pox,     and 

wished  himself  in   London. 

Dr.  Jenner  to  Dr.  Woodville. 

"  My  Dear  Sir, — I  am  extremely  obliged  to  you  for  your 
letter,  and  most  sincerely  wish  circumstances  would  admit  of 
my  being  at  your  elbow  while  you  conduct  your  experiments 
on  the   interesting   subject  before  you. 

"  I  answer  your  letter  by  return  of  post,  to  suggest  (what 
perhaps  is  needless)  the  immediate  propriety  of  inoculating 
those  who  may  resist  the  action  of  the  Cow  Pox  matter,  and 
may   have  been  exposed  to   variolous   contagion   at  the  hospital. 


154  EDWARD  JENNER. 

After  the  description  you  have  given,  there  can  be  no  doubt, 
I  think,  that  the  disease  among  the  cows  in  Gray's  Inn  Lane 
is  the  true,  and  not  a  species  of  the  spurious  Cow  Pox.  In 
the  account  of  the  appearance  on  the  milker's  hand,  the  report 
of  my  friend  Tanner  merits  great  confidence.  Whether  to  the 
cold  season  of  the  year  or  to  what  other  cause  it  can  be  ascribed 
I  know  not,  but  out  of  six  patients  that  I  lately  inoculated  two 
of  them  only  were  infected.  An  inflammation  was  excited  in 
the  arms  of  all,  and  in  some  of  those,  whose  constitutions 
would  not  feel  it,  it  did  not  die  away  for  more  than  a  week, 
and  even  went  on  so  as  to  leave  a  little  scab  behind. 

"It  has  not  happened  so,  generally.  However,  once  in  the 
course  of  the  last  summer,  I  was  foiled  in  a  similar  way.  Three 
or  four  servants  at  a  farm  were  carefully  inoculated  with  matter 
fresh  from  a  cow: — they  all  resisted  it,  but  in  the  course  of  the 
season,  all  of  them  were  infected  by  milking  the  cows.  As  every 
case  of  Cow  Pox  is  to  be  considered  as  a  case  of  inoculation,  I 
mention  these  facts  to  you,  that  it  may  be  considered  whether 
some  mode  more  certain  of  infecting  the  subject  than  that  at 
present  in  use   with  variolous  matter  may  not  be  thought  of. 

"  It  would  imitate  the  casual  mode  more  closely  were  we  first 
by  scratch  or  puncture  to  create  a  little  scab,  and  then,  removing 
it,  apply  the  virus  on   the  abraded  part. 

"  I  am  shortly  going  to  publish  an  appendix  to  my  late 
pamphlet  (which,  by  the  way,  I  hope  you  received,  as  I 
directed  it  to  be  sent  to  you  before  I  left  London)  to  mention 
the  precaution  of  destroying  the  pustule,  and  the  general  sources 
of  spurious  Cow  Pox,  etc.,  etc. 

"  I  shall  also  point  out  the  result  of  one  of  the  cases  where 
caustic  was  used  soon  after  the  symptoms  of  infection  appeared 
(see  page  41').  This  I  shall  concisely  relate  to  you  now.  About 
six  weeks  ago,  I  inoculated  M.  James  (see  page  40^)  with  fresh 
Small  Pox  matter,  and  at  the  same  time  exposed  her  to  the 
effluvia  of  a  patient.  The  appearances  of  the  arm  were  just 
the  same  as  if  she  never  had  had  either  Small  Pox  or  Cow  Pox ; 
and    on    the   eighth  day,    I   expected,  from    the  appearances,   she 

^  Vide\o\.  ii.,  p.  174. 


LIFE  AND  LETTERS.  155 

would  be  ill.  She  was  a  little  hotter  than  usual  during  the 
night,  but  slept  well,  and  it  was  supposed  that  a  rash  appeared 
for  the  space  of  a  few  hours  about  the  wrists.  1  inserted  matter 
from  her  arm  into  two  other  subjects,  a  boy,  and  a  woman  of 
fifty.  The  bo}'  had  about  half  a  dozen  pustules,  two  or  three 
of  which  were  fairly  characterised.  Their  appearance  was 
preceded  b}'  a  pretty  general  rash.  The  woman,  though  she 
felt  an  indisposition,  had  not  a  single  pustule.  A  person  near 
sixty  years  of  age,  who  had  in  the  early  period  of  her  life  been 
exposed  to  the  contagion  of  the  Small  Pox  and  resisted  it, 
fully  exposed  herself  now  to  this  infection.  She  sickened  in 
consequence,  and  had  three  pustules,  one  of  which  became  a 
perfect  Small  Pox  pustule.  It  would  be  unfair  to  draw  positive 
conclusions  from  such  scanty  precedents,  but  yet  they  lead  one 
to  hope  that  a  mild  variety  of  the  Small  Pox  might  thus  be 
actually  created." 

******* 

Jenner  had  recommended  that  caustic  should  be 
employed  to  destroy  the  pustule,  but  this  was 
strongly  objected  to  by  both  Pearson  and  Wood- 
ville.  Pearson  alluded  to  this  in  a  letter,  February 
15th,  and  at  the  same  time  mentioned  the  prospect  of 
increasing  opposition  to  the   new  practice. 

"  On  telling  Dr.  Woodville  that  I  had  been  anxious  about 
your  publishing  the  use  of  the  caustic,  he  replied  '  that  would 
ha\e  damned   the  whole  business.' 

"Be  assured  that  if  the  practice  cannot  be  introduced  without 
the  caustic,  or  call  it  by  any  other  name,  it  will  never  succeed 
with  the  public.  I  cannot  yet  tell  whether  all  my  patients  have 
had  sufficient  affection  of  the  constitution.  There  has  not  been 
time  for  a  second  inoculation  and  with  variolous  matter.  Some 
of  the  patients  had  undergone  the  Small   Pox. 

"  Dr.  Parr's  letter  you  shall  see  in  town,  merely  to  satisfy 
you,  but  it  contains  nothing  that  is  relative  beside  what  I 
extracted   from    it.     1   must   tell   you   that   Dr.    Parr  has   written 


156  EDWARD  JENNER. 

to  me  to  say  that  although  he  '  is  not  yet  convinced,  he  is 
staggered,  and  begins  to  doubt.'  We  shall  have  to  experience 
soon  a  number  of  gnat  bites.  If  the  practice  is  likely  to  go 
forward,  it  will  excite  opposition.  What  obligation  society  owes 
to  those  worthy  and  liberal  men  who  favour  the  public  with 
their  a  priori  opinions,  having  never  seen  the  disease,  and  not 
even  understanding  the  arguments  !  !  Tantaene  animis  coeles- 
tibus  irae  ! 

"  I  trust  we  shall  establish  facts  enough  to  prove  whether 
Cow  Pox  inoculation  extinguishes  that  of  the  variola  or  not. 
We  have  got  able,  candid,  and  worthy  men  on  our  side,  and 
proceeding,  as  we  have  all  done,  circumspectly,  I  do  not  feel  any 
dread  from  the  opponents  who  have  yet  taken  the  field." 

In  the  same  letter,  Pearson  enclosed  a  bit  of  thread 
infected  with  the  virus,  and  Jenner  made  a  number  of 
inoculations,  and  reported  the   results. 

Dr.  Jenner  to  Dr.  Pearson. 

"  Berkelev,  March  i^ih,  1799. 

"  My  Dear  Sir, — I  received  your  letter  while  I  was  writing 
to  Dr.  Woodville,  and  requested  him  to  transmit  to  you  the 
result  of  the  inoculation  with  the  London  virus.  I  hope  he 
did  not  fail  to  execute  my  wishes.  Twelve  patients  have  since 
been  inoculated  with  matter  produced  by  this  virus.  They  all 
took  the  infection.  This  is  the  ninth  day,  and  they  appear  a 
little  ill-no  eruptions  yet.  The  character  of  the  arm  is  just  that 
of  Cow  Pox,  except  that  I  do  not  see  the  disposition  in  the 
pustule  to  ulcerate  as  in  some  of  the  former  cases.  I  am  the 
more  induced  to  believe  this  to  be  the  genuine  Cow  Pox  from 
the  following  circumstance  : — 

"  One  of  the  boys  inoculated  sickened  the  preceding  day 
with  the  measles,  which  went  through  its  course.  Yet  the 
pustule  advanced  with  the  same  regularity  as  if  the  measles 
had  not  been  present.  Now  this  would  not  have  been  the  case, 
1  presume,  had  variolous  matter  been  inserted  into  the  skin 
under  similar  circumstances.     No  Cow  Pox  yet  in  the  country! 


LIFE  AND  LETTERS.  157 

Should  it  appear  within  a  particular  district  I  shall  undoubtedly 
know  it.  It  cannot  now  be  long  before  I  shall  see  you  in  town  ; 
at  least  I  can  speak  with  as  great  a  certainty  of  being  soon 
there   as   a  medical  man   can. 

"  I  hear  of  a  child  covered  over  with  pustules  at  the  Small 
Pox   Hospital.      What   are  they  ? 

'*  I  am  glad  to  find  that  the  disposition  for  forming  eruptions 
among  your  patients  does  not  increase,  as  you  tell  me  that 
none  of  your  last  inoculated  patients  had  any,  and  that  Mr. 
Rolph's  children  went  through  the  disease  without  them. 
Tanner,  I  find,  could  not  succeed  in  giving  the  Cow  Pox  to  the 
veterinary  cow  in  a  direct  way,  that  is,  by  inserting  the  virus 
into  a  sound  part  of  the  nipple,  in  the  same  way  as  all  experi- 
ments have  hitherto  been  conducted  to  confute  my  notions 
with  the  matter  of  grease  ;  but  when  he  found  a  part  of  the 
nipple  that  was  previously  affected  with  a  sore,  and  applied 
the  matter  there,  it  took  effect  immediately.  With  best  respects 
to  Mrs.   Pearson, 

"  I   remain,  dear  sir, 

"  Yours  very  truly, 

"  E.  Jenner." 

In  about  two  months,  Pearson  and  Woodville  had 
inoculated  upwards  of  one  hundred  and  sixty  persons, 
and  above  sixty  were  afterwards  inoculated  with  Small 
Pox.  but  none    took    the    infection.^ 

On  March  12th,  1799,  Pearson  sent  a  letter  enclosing 
an  infected  thread  to  two  hundred  practitioners,  request- 
ing them   to  try   its   effects  and   report   the  results. 

Pearson  also  sent  virus  to  Paris,  Berlin,  Vienna, 
Geneva,  and  to  Hanover,  Portugal,  America,  and 
also  supplied  the  army. 

In     May.      1799,     Woodville     published     his     report. 

Vide,  p.  163. 


is8  EDWARD  JENNER. 


Between  the  21st  of  January  and  the  i8th  of  March, 
he  had  inoculated  two  hundred  persons,  and  within  a 
short  time,  four  hundred  more.  In  fact,  Pearson  and 
Woodville  had  so  succeeded  in  promoting  Cow  Pox 
inoculation,  by  their  energy  and  zeal,  and  by  dis- 
tributing lymph  and  disseminating  information  about 
the  new  inoculation,  that  the  whole  medical  world  was 
in  a  state  of  agitation. 

It  was  obvious  that  Jenner's  limited  efforts,  when 
compared  with  the  work  of  Pearson  and  Woodville, 
were  in  danger  of  sinking  into  insignificance.  Jenner 
without  delay,  issued  a  counterblast  in  the  form  of  a 
pamphlet,^  the  data  of  which  had  been  hurriedly  put 
together.  Criticisms  also,  were  overwhelming  him, 
and,  according  to  Baron,  he  began  to  feel  deeply  the 
weight  of  the  responsibility  which  rested  on  him  from 
the  publication  of  the  Inquiry.  Hence  we  find  him 
again    appealing    to    his    friend    Gardner    for    help. 

Dr.  Jenner  to  Mr.   Edward  Gardner. 

"  Dear  Gardner, — There  never  was  a  period  in  my  existence 
when  my  situation  called  so  loudly  for  the  assistance  of  my 
literary  friends  as  the  present.  Though  my  bark  will,  with  flying 
colours,  reach  the  shore  at  last,  yet  it  is  now  in  a  storm. 

"  I  am  beset  on  all  sides  with  snarling  fellows,  and  so  ignorant 
withal  that  they  know  no  more  of  the  disease  they  write  about 
than  the  animals  which  generate  it.  The  last  philippic  that  has 
appeared  comes  from  Bristol,  and  is  communicated  by  Dr.  Sims  of 
London.  Sims  gives  comments  on  it  in  harsh  and  unjustifiable 
language.  It  is  impossible  for  me,  single-handed,  to  combat  all 
my  adversaries. 

'    ]^ide  vol.  ii.,  p.  155. 


LIFE  AND  LETTERS. 


159 


"  Standing,  as  I  do,  before  so  awful  a  tribunal,  my  friends  will 
volunteer  their  counsel  and  immediately  appear  in  court. 

"  M}^  intended  pamphlet  has  only  been  looked  over  in  a  cursory 
\\z.y.  Ever}^  sentence  must  be  again  revised  and  weighed  in  the 
nicest  balance  that  human  intellect  can  invent.  The  eyes  of  the 
philosophic  and  medical  critic,  prejudiced  most  bitterly  against 
the  hypothesis,  will  penetrate  its  inmost  recesses,  and  discover 
the  minutest  flaw  were  it  suffered  to  be  present.  Language  I  put 
out  of  the  question  :  the  matter  is  what  I  allude  to. 

"  Give  me  as  much  of  your  company  as  you  can,  and  as 
speedily. 

"  Yours,  very  faithfull}', 

"  E.  Jenner. 

"  Thursday,  Marxli  yth,  1799." 

But  more  trouble  was  in  store  for  him.  Georofe 
Jenner  happened  to  be  in  London,  and  became 
greatly  alarmed  at  the  part  played  by  Pearson  and 
Woodville,  particularly  the  former.  He  wrote  off 
post-haste  to  his  uncle,  warning  him  that  Pearson 
would  become  the  chief  person  known  in  the  busi- 
ness, and  that,  if  he  did  not  ^o  at  once  to  London, 
his  chance  of  obtaining  fame  and  fortune  would  be 
lost  for  ever. 

G.  C.  Jenner  to  Dr.  Jenner. 

"Norfolk  Street,  March  iith,  1799. 

"  Mv  Dear  Sir, — After  what  Mr.  Paytherus  has  written  to  you, 
it  will  be  needless  for  me  to  say  anything  to  urge  the  necessity  of 
your  coming  to  town  to  wear  the  laurels  you  have  gained,  or  to 
prevent  their  being  placed  on  the  brows  of  another. 

"  I  shall  only  state  a  few  facts  I  have  got  possession  of  since  I 
wrote  to  you  last.  Dr.  Pearson  is  going  to  send  circular  letters  to 
the  medical  gentlemen  to  let  them  know  that  he  will   supply  them 


i6o  EDWARD  JENNER. 


with  Cow  Pox  matter  upon  their  appHcation  to  him,  by  which 
means  he  will  be  the  chief  person  known  in  the  business,  and 
consequently  deprive  you  of  that  merit,  or  at  least  a  great  share 
of  it,  which  is  so  justly  your  due.  Doctor  P.  gave  a  public  lecture 
on  the  Cow  Pox  on  Saturday  last.  Farmer  Tanner  was  there. 
Doctor  Pearson  adopted  your  opinions,  except  with  regard  to  the 
probability  of  the  disease  originating  in  horses'  heels.  He  spoke 
of  some  unsatisfactory  experiments  having  been  made  by  inoculat- 
ing from  the  greasy  heels  ;  but  when  we  consider  how  difficult  it 
was  to  communicate  the  disease  from  one  cow  to  another  by 
inoculation,  we  are  not  to  wonder  at  the  still  greater  difficulty 
in  communicating  it  from  the  horse  to  the  cow.  The  farmer  says 
Dr.  Pearson  was  wrong  in  some  part  of  his  lecture,  which  he  took 
the  liberty  to  tell  him. 

"  Mr.  Paytherus  is  much  disappointed  not  to  receive  any  letter 
from  you  by  this  day's  post,  but  hopes  you  may  be  coming  up 
to-da}',  and  therefore  did  not  write.  All  your  friends  agree  that 
now  is  your  time  to  establish  your  fame  and  fortune  ;  but  if  you 
delay  taking  a  personal  active  part  any  longer,  the  opportunity  will 
be  lost  for  ever.  If  Dr.  Pearson  does  not  intend  to  endeavour  to 
give  the  merit  to  himself,  why  should  he  quibble  about  the  name 
you  gave  the  disease  ?  The  eruption  he  rails  the  vaccinoits 
eruption. 

"  Your  affectionate  nephew, 

"  G.  C.  Jenner. 

"  Mr.  Paytherus  has  just  told  me  that  a  copy  of  Doctor  Pearson's 
lecture  was  exhibited  yesterday  at  Sir  Joseph  Banks's.  When  I 
get  a  sight  of  it  I  will  send  you  an  account  of  it." 

Jenner  promptly  wrote  to  his  counsellor  and  guide, 
proposing    counter-action. 

Dr.  Jenner   to  Mr.   Edward  Gardner. 

''Berkeley,  Wednesday,  1799. 
"  Dear  Gardner, — A  letter  I  have  just  received  from  G.  Jenner 
informs  me  that  Dr.  Pearson  on  Saturday  last  gave  a  public  lecture 


LIFE  A  AW  LETTERS.  i6i 


on  the  Cow  Pox,  and  that  it  was  publicly  exhibited  at  Sir  J 
Banks's  on  Sunday  evening.  He  has  also  given  out  that  he  wil 
furnish  any  gentlemen  at  a  distance  with  the  virus. 

"  As  this  is  probably  done  with  the  view  of  showing  himself  as 
the  first  man  in  the  concern,  should  not  some  neatly-drawn  para- 
graphs appear  from  time  to  time  in  the  public  prints,  by  no  means 
reflecting  on  the  conduct  of  P.,  but  just  to  keep  the  idea  publicly 
alive   that   P.  was  not  the  author  of  the  discovery — I  mean   Cow 

Pox  inoculation  ? 

"  Yours  trul}', 

"E.  J." 

On  the  2ist  of  March.  Jenner  acted  on  the  advice 
of  his  friends,  and  left  Berkeley  for  London.  On  the 
23rd,  he  saw  Woodville,  who  informed  him  that  in  one 
of  his  cases  the  Cow  Pox  was  communicated  by  effluvia, 
and  the  patient  had  had  it  in  tke  confluent  way}  In  the 
same  month,  Woodville  published  his  Reports,  in  which 
he  concluded  that  Cow  Pox  manifested  itself  sometimes 
as  an  eruptive  disease  of  great  severity,  for  three  or  four 
cases  out  of  five  hundred  had  been  in  considerable 
danger,  and  one  case  died.  Baron  says  that  these 
results  proved  well-nigh  fatal  to  the  cause  of  vaccina- 
tion. However,  in  other  localities  where  Woodville  s 
lymph  had  been  employed,  much  happier  results  were 
met  with.  One  explanation  was,  that  as  Woodville 
had  vaccinated  in  a  variolous  atmosphere.  Cow  Pox 
and  Small  Pox  occurred  simultaneously.  Jenner  had 
■  employed  the  Woodville  lymph,  and  inoculated  his 
grand-nephew,  Stephen  Jenner,  and  a  boy  of  the 
name   of    Hill,   who  was    about    four  years   old.      With 

'  Baron,  loc.  cit.,  vol.  i.,  p.  322. 
VOL.  I.  I  I 


1 62  EDWARD  y£AL\'EA\ 


lymph  from  the  arm  of  the  boy  Hill,  Jenner  inoculated 
two  of  the  children  of  his  friend,  Mr.  Hicks,  and  at 
the  same  time,  i6  others,  and  with  matter  taken  from 
this  source,  his  nephew,  Henry  Jenner,  successfully 
vaccinated  a  child  twenty  hours  old,  and  no  eruptions 
resulted  in  any.  The  same  stock  supplied  Mr.  Marshall 
with  virus  for  inoculations  on  107  persons,  and  in  only 
one  or  two  cases  were  there  any  eruptions. 

jenner  had  left  London  in  June  ;  but  in  order  to 
study  the  effects  of  lymph  from  the  London  dairies, 
he  procured  .  before  his  departure  some  virus  from 
Mr.  Clark's  farm  at  Kentish  Town,  and  sent  it  to  Mr. 
Marshall  by  his  friend  Mr.  Tanner,  who  used  it  on  127 
cases  without  any  eruptions  resulting.  Jenner  there- 
fore concluded  that,  in  Woodville's  cases,  the  eruptions 
resulted  from  "  the  action  of  variolous  matter  which 
crept  into  the  constitution  with  the  vaccine."^ 

Roth  Woodville"  and  Pearson"  acknowledged  after- 
wards that  the  eruptions  arose  from  variolation. 

"  It  is  true  that  many  of  these  vaccine  cases  were  conjoined 
with  the  Small  Pox  from  the  influence  probably  of  the  variolous  in- 
fection, but  as  the  eruptive  cases  exhibited  the  genuine  Cow  Pock 
on  the  part  inoculated,  and  the  matter  of  it  very  generally  propa- 
gated the  Vaccina  without  eruptions,  in  private  practice  and  in  the 
country,  it  is  fair  to  admit  them  into  the  class  of  Cow  Pock  cases." 


'  Vide  vol.  ii.,  p.  252  ;  vol.  i.,  p.  244  and  p.  184  ;  and  Moore.  History 
and  Praciice  of  Vaccination,     p.  26. 

-  Woodville.     Observations  on  tlie  Cow  Pox.     1800.     p.  21. 

^  Pearson.  An  Examination  of  the  Report  of  tlic  Committee  of  tlie 
House  of  Commons.     1802.    p- 49. 


J.IFE  AXD  LE'JTERS.  163 

This  accident  was  far  from  proving  "well-nigh  fatal" 
10  the  interests  of  vaccination  ;  it  was,  on  the  contrary, 
the  most  fortunate  occurrence  for  Jenner  and  his  cause. 
1  regard  it  as  having  been  ])roductive  of  results  which 
completely  turned  the  scale  of  opinion  in  favour  of 
the  new  inoculation.  The  variolous  test,  in  Jenner's 
cases,  had  been  fir  from  convincinsf.  But  here  were 
60  cases  in  which  the  variolous  test  appeared  to  settle 
the  question  conclusively,  tor  neither  inoculation  nor 
exposure  to  infection  produced  any  result.  The  Cow 
Pox  got  the  credit  in  these  60  and  many  similar  cases, 
and  this  constituted  one  of  the  stock  arofuments  in 
favour  of  the  prophylactic  power  of  Cow  Pox.  But 
the  fact  that  these  patients  had  been  \^ariolated  (and 
perhaps  Cow  Poxed  at  the  same  time),  and  were  there- 
fore naturally  protected  from  a  subsequent  attack  of 
Small  Pox,  was  overlooked  and  tbrgotten.  ]\Iany 
wavering  opinions  were  secured  in  fivour  of  the  new 
inoculation  by  the  immunity  which  was  demonstrated 
on  applying  the  variolous  test  in  these  cases  ;  but,  I 
must  repeat,  Ike  immtmity  7^'as  produced  by  small  pox 
which  was  introduced  into  the  constitution  as  the  result 
of  vaccinating  in  a  variolous  atmosphere  or  of  employing 
contaminated  lancets} 

It  is  not  then  surjjrising  that  Cow  Pox  inoculation 
continued  to  gain  ground,  and  that  distinguished  per- 
sons,  in    different    parts    of  the    kingdom,    adopted    the 


Vide  vol.  ii.,  pp.  137 — 147. 


EDWARD   JENNER. 


new  practice,  and  exerted  themselves  to  make  it  as 
widely  known  as  possible.  Ladies  were  particularly 
conspicuous  in  this  work,  becoming  most  energetic  and 
successful  vaccinators. 

Jenner  at  this  period  resided  at  Berkeley  and 
Cheltenham.  His  correspondence  on  the  subject  of 
vaccination  so  increased,  that  he  had  little  leisure  for 
other  employment.  It  was  at  this  time  that  various 
influential  members  of  the  profession  opposed  Cow  Pox 
inoculation.  But  Jenner  enlisted  a  powerful  advocate  in 
the  person  of  Mr.  Ring.  Ring  not  only  replied  to  the 
objections  which  were  brought  forward,  but  also  collected 
together  a  number  of  medical  men  who,  having  satis- 
fied themselves  of  the  efficacy  of  Cow  Pox  inoculation, 
put  their  signatures  to  the  following  document : — 

"  Many  unfounded  reports  having  been  circulated,  which  have  a 
tendency  to  prejudice  the  public  against  the  inoculation  for  Cow 
Pox  :  We  the  undersigned  physicians  and  surgeons  think  it  our 
duty  to  declare  our  opinion  that  those  persons  who  have  had 
the  Cow  Pox  are  perfectly  secure  from  the  future  infection  of 
the  Small  Pox." 

Here  followed  the  signatures  of  thirty-three  physicians 
and  surgeons. 

In  London,  in  the  meantime,  Dr.  Pearson  had 
determined  to  organise  an  Institution  for  inoculation 
of  Cow  Pox.  He  appointed  a  vaccine  board,  of  which 
the  chief  place  was  occupied  l3y  himself,  and  the  Duke 
of  York  consented  to  become  a  patron.  In  order  that 
Jenner    should    be    connected    in    some    way    with    the 


LIFE  AND   LETTERS.  165 

Institution,  Pearson  wrote  offering  to  make  him  an  extra 
corresponding  physician.  Jenner  thought  that  sufficient 
consideration  had  not  been  shown  liim  in  the  matter, 
and  wrote  a  hasty  letter  to  Pearson,  decHning  the  offer. 

Dr.  Jennkr  to  Dr.   Pearson. 

"  Berkeley,  Dec.  17,  1799. 

"Sir, — 1  received  your  letter  of  the  lOth  instant,  and  confess 
I    felt  surprised  at  the  inlbrmation   it  conveys. 

"  It  appears  to  me  somewhat  extraordinary  that  an  institution 
formed  upon  so  large  a  scale,  and  that  has  for  its  object  the 
inoculation  of  the  Cow  Pox,  should  have  been  set  on  foot  and 
almost  completely  organised  without  m}^  receiving  the  most 
distant  intmiation  of  it.  The  institution  itself  cannot,  of  course, 
but  be  highly  ilattering  to  me,  as  I  am  thereby  convinced  that  the 
importance  of  the  fact  I  imparted  is  acknowledged  by  men  of  the 
first  abilities.  But  at  the  same  time,  allow  me  to  observe  that  if 
the  vaccine  inoculation,  from  unguarded  conduct,  should  sink  into 
disrepute  (and  you  must  admit.  Sir,  that  in  more  than  one  instance 
has  its  reputation  suffered),  I  alone  must  bear  the  odium.  To  you, 
or  any  other  of  the  gentlemen  whose  names  you  mention  as  filling 
up  the  medical  departments,  it  cannot  possibly  attach. 

"  At  the  present  crisis  I  feel  so  sensibly  the  importance  of  the 
business  that  I  shall  certainly  take  an  early  opportunity  of  being 
in  London.  For  the  present  I  must  beg  leave  to  decline  the 
honour  intended   me. 

''I  remain,  Sir,  your  obedient  Servant, 

"  E.  Jennek." 

Jenner  left  Berkeley  for  London-  on  the  28th  of 
January,  1800,  in  order  to  watch  what  was  going  on 
there,  and  shortly  afterwards  he  published  A  Continua- 
tion of  Facts  and  Observations  Relative  to  the  V^ariolce 
Vaccina:.''      Soon  after  his  arrival,  Jenner  wrote  to  Lord 


Vide  vol.  ii.,  p.  247. 


i66  EDWARD  JENNER. 


Eo-remont.  askino-  for  an  interview  to  enable  him  to 
submit  a  plan  by  which  the  country  might  derive 
the  advantages  of  the  new  antidote,  and  to  profit  by 
his  advice.  Jenner  had,  also,  an  interview  with  the 
Duke  of  Clarence,  and  subsequently  submitted  the 
following   proposals   to   Lord   Egremont  : — 

PROPOSALS  BY  DR.  JENNER  FOR  A  PUBLIC  INSTITU- 
TION FOR  VACCINE  INOCULATION. 

(for  lord  egremont.) 

"  Having  now  pursued  the  inquiry  into  the  nature  of  the  Cow 
Po::  to  so  great  an  extent  as  to  be  able  positively  to  declare  that 
those  who  have  gone  through  this  mild  disease  are  rendered 
perfectly  secure  from  the  contagion  of  the  Small  Pox  ;  and  being 
convinced  from  numberless  instances  that  the  occupations  of  the 
mechanic  or  the  labourer  will  meet  with  no  interruption  during  its 
progress,  and  the  infected  and  uninfected  may  mingle  together  in 
the  most  perfect  safety,  I  conceive  that  an  institution  for  the 
gratuitous  inoculation  of  the  lower  classes  of  society  in  the 
metropolis  would  be  attended  with  the  most  beneficial  conse- 
quences, and  that  it  might  be  so  constituted  as  to  diffuse  its 
benefits  throughout  every   part   of  the   British   Empire. 

"  Edw.  Jenner. 

"  London,  Alarcli  \bfh,  1800." 

In  order  to  diffuse  the  advantages  of  the  institution  for 
promoting  the  inoculation  of  the  Cow  Pox  as  widely  as  possible, 
it  is  proposed : 

"  1st.  That  communications  be  made  to  the  principal  medical 
gentlemen  in  London  and  throughout  the  British  Empire,  acquaint- 
ing them  with  the  nature  of  the  Institution,  and  soliciting  their 
associating  as  honorary  members. 

"  2ndly.  That  a  Physician  be  appointed  who  shall  superintend 
the   medical   department. 

'  3rdl\".  That  a  house  be  appropriated  in  some  convenient  part 
of  this    metropolis,   containing    the   necessary    apartments    for    a 


LTFE  AND  LETTERS.  167 


medical  attendant,  a  secretary,  porter,  etc.  Apartments  also  for 
the  reception  of  the  patients  sent  for  inoculation,  and  for  the 
occasional  reception  of  those  who  may  choose  to  aid  the 
charity. 

'*4thly.  That  virus  for  inoculating  the  Cow  Pox  be  sent  to  all 
such  honorary  members  as  may  make  a  proper  application  for  it  at 
the  apartments  of  the  Institution,  and  that  none  be  sent  forth 
without  the  signature  of  the  superintending  Physician,  as  a  test  of 
its  being  genuine. 

"  Sthly.  That  the  virus  be  accompanied  with  directions  for 
its  use,  and  (to  guard  against  error)  with  some  general  observa- 
tions on  the  nature  of  the  disease. 

"  Gthl}'.  That  the  Institution  be  supported  by  voluntary  con- 
tribution. 

"  /thly.   That   an   annual   subscriber  of  ....   be   a   Governor. 

"  8thly.  That  the  Governors  meet  at  the  apartments  the  first 
day  of  every  month  for  the  inspection  of  the  reports  relative  to  the 
general  progress  of  the  inoculation,  etc.,  etc. 

"  9thl3\  That  an  abstract  of  the  reports  be  published  as  often 
as  it  may  be  deemed  proper." 

Ultimately,  Jenner  succeeded  in  inducing  the  Duke 
of  York  and  Lord  Egremont  to  withdraw^  from  the 
Vaccine  Institution,  formed  by  Pearson,  and  thus, 
according  to  Baron,  Jenner  defeated  the  ambitious 
designs   of  those    who  sought  for  high  patronage. 

A  great  piece  of  news  for  Jenner  was  the 
announcement  that  the  King  had  permitted  him  to 
dedicate  the  second  edition  of  the  Inquiry  to  His 
Majesty ;  he  was  presented  by  Lord  Berkeley,  and 
later  had  an  interview  with  his  Royal  Highness  the 
Prince  of  Wales. 

Concerning  the  progress  of  vaccination  in  London, 
at  this  time,  Jenner  wrote  to   Mr.   Shrapnell  : — 


1 68  EDWARD  JEN^ER. 


"  Pray  write  without  delay  to  Tierney,  and  tell  him  how  rapidly 
the  Cow  Pox  is  marching  over  the  metropolis,  and,  indeed,  through 
the  whole  island.  The  death  of  the  three  children  under  inocu- 
lation with  the  Small  Pox  will  probably  give  that  practice  the 
Brutus-stab  here,  and  sink  for  ever  the  tyrant  Small  Pox.  Would 
Tierney  like  to  have  a  little  virus,  that  the  Cow  Pox  inoculation 
may  be  set  going  under  his  own  eye  at  Edinburgh  ?  I  should  be 
happy  to  furnish  him.  Let  him  know  that  my  new  edition  men- 
tioning his  name,  with  the  appendix,  is  published.  A  very  little 
attention  would  place  the  practice  in  its  proper  light  in  Edinburgh, 
a  thing  devoutly  to  be  wished." 

From  this  time  until  he  left  London,  he  was  busily 
engaged  in  promoting  the  cause  of  the  nev^  inoculation, 
by  meeting  his  professional  brethren,  and  by  discussions 
at  the  medical  societies.  And,  finally,  he  left  London 
Avith  his  nephew  George,  on  the  23rd  of  June,  for  Oxford, 
where  he  had  the  gratification  of  obtaining  the  signa- 
tures of  a  number  of  learned  scientists  to  the  following 
testimonial  drawn  up  by  Sir  C.   Pegge  : — 

"We,  whose  names  are  undersigned,  are  fully  satisfied  upon 
the  conviction  of  our  own  observation,  that  the  Cow  Pox  is  not 
only  an  infinitely  milder  disease  than  the  Small  Pox,  but  has  the 
advantage  of  not  being  contagious,  and  is  an  effectual  remedy 
against  the  Small  Pox." 

On  the  13th  of  July,  1800,  Jenner  went  to  Chelten- 
ham. His  time  was  principally  occupied  in  correspond- 
ence, in  explaining  the  failures  reported  to  him,  and  in 
collecting  evidence  in  support  of  his  theory.  It  was 
at  this  period  that  the  Earl  of  Berkeley  took  the  lead 
in    advocating   some  practical   expression   of  the   public 


LIFE  AXD   LtTTERS.  169 


feeling  in  the  county.      He  induced  many  to  subscribe, 
and  Jenner  was  presented  with  a  service  of  plate. 

Jenner  took  great  interest  in  this  testimonial.  In 
a  letter  to  his  friend  Hicks,  he  refers  to  it,  as  well  as 
to  the  necessity  of  collecting  cases  of  those  who  had 
resisted  variolous   inoculation  after  Cow   Pox. 

"  Darke,  when  at  Cheltenham,  mentioned  some  strong  cases  to 
me  of  the  preventive  power  of  Cow  Pox.  He  can  also  favour 
me  with  cases  of  those  who  have  resisted  variolous  inoculation, 
because  they  had  undergone  the  Cow  Pox  at  some  distant  period 
of  their  lives.  Evidence  of  this  kind  I  cannot  obtain  too  abun- 
dantl}',  as  it  is  at  this  point  the  public  mind  makes  a  pause,  from 
the  early  impression  that  was  made  of  its  proving  a  temporary 
preventive  only.  This  must  be  the  form  :  first  state  the  evi- 
dence of  the  preventive  powers  of  Cow  Pox,  and  then  add  any 
comment  you  please  upon  the  utility  of  the  discovery.  You  may 
compare  the  anxiety  you  felt  on  the  variolous  inoculation  in  your 
family,  with  your  feelings  respecting  the  vaccine.  Say  nothing 
of  Paul.  It  is  time  enough  to  determine  how  the  subscription 
money  shall  be  disposed  of  A  gold  cup  I  should  make  choice 
of,  in  preference  to  anything  else,  if  I  may  be  allowed  to  name 
what  it  shall  be.  Have  you  thought  of  an  appropriate  device, 
etc.?  What  think  you  of  the  cow  jumping  over  the  moon?  Is  it 
not  enough  to  make  the  animal  jump  for  joy  ?  " 

In  1801,  Mr.  Ring  reported  a  case  of  Small  Pox- 
after  Cow   Pox,   and  Jenner  replied — 

"Your  case  would  certainly  have  raised  a  clamour  a  year  or 
two  ago  ;  but  now  the  phenomena  of  Cow  Pox  have  been  so 
fully  examined,  and  are  so  well  understood,  none  but  the  igno- 
rant and  illiberal  will  lay  any  stress  on  it  for  a  moment." 

But  the  way   in    which    Jenner    answered    those  who 


EDWARD  JENNER. 


reported  successful  cases  of  inoculation  of  Small  Pox 
after  Cow  Pox,  may  be  gathered  from  the  following 
letters  : — 

Dr.  Jenner  to  Mr.  Boddington. 

"London,  April  2\sf,  1801. 
"  Dear  Sir, — How  a  gentleman,  following  a  profession  the 
guardian  angel  of  which  is  fame,  should  have  so  committed  him- 
self as  to  have  called  this  a  case  of  Small  Pox  after  Cow  Pox 
is  not  only  astonishing  to  me,  but  must  be  so  to  all  who  know 
anything  of  the  animal  economy.  He  should  have  known  that 
upon  the  skin  of  every  human  being  that  possesses  a  more  than 
ordinary  share  of  irritability,  the  insertion  of  the  variolous  virus 
(whether  the  person  has  previously  had  the  Cow  Pox  or  Small 
Pox)  will  produce  either  a  pustule  or  a  vesicle  capable  of 
communicating  the  Small  Pox,  and  frequently  attended  with 
extensive  inflammation." 

Dr.    Jenxer    to    Dr.    Evans,    Ketley-Bank. 

"  How  little  he  (Mr.  Cartwright)  must  have  known  of  the 
agency  of  variolous  matter,  to  have  argued  as  he  has  done. 
Wonderful  as  it  is,  yet  there  are  abundant  facts  to  prove,  that 
the  insertion  of  variolous  matter  into  the  skin  has  produced  a 
virus  fit  for  the  purpose  of  continuing  the  inoculation  ;  and  yet 
the  person  who  has  borne  it,  and  on  whose  skin  it  was  gene- 
rated, has  subsequently  been  infected  with  the  Small  Pox,  on 
exposure  to  its  influence.     Just  so  with  the  vaccine.  .   .  . 

"  Vaccine  inoculation  has  certainly  unveiled  many  of  the  mys- 
terious facts  attendant  upon  the  Small  Pox  and  its  inoculation. 
How  often  have  we  seen  (apparently)  the  full  effect  on  the  arm 
from  the  insertion  of  variolous  matter,  indisposition,  and  even 
eruptions  following  it,  and  its  termination  in  an  extensive  and 
deep  cicatrix  ;  and  yet,  on  exposure,  the  person  who  underwent 
this,  has  caught  the  Small  Pox." 

In    the   same  year,   Jenner    published    his    account    of 


LIFE  AND  LETTERS.  171 

the  orio-in  of  the  \-accine  inocuhition.  He  maintained 
that  his  inquiries  conimenced  about  1776.  and  that 
his  attention  had  been  drawn  to  the  sul^ject  l)y  the 
failure  to  inoculate  those  who  had  had  Cow  Pox.  He 
said,  a  vague  opinion  prevailed  that  Cow  Pox  was 
a  preventive  of  the  Small  Pox,  but  this  opinion  was 
comparatively  new,  and  apparently  originated  at  the 
time  of  the  introduction  of  the  Suttonian  method. 
He  added  that  in  the  course  of  the  investigation 
he  had  found  some  ''who  seemed  to  have  undergone 
the  Coiu  Pox"  and  were  inoculated  with  Small  Pox 
with  success.  "  This,"  he  says,  "  for  a  while  damped, 
but  did  not  extinguish,  my  ardour."  He  was  led  to 
assume  the  existence  of  a  "true"  and  a  "spurious" 
Cow  Pox,  the  latter  possessing  no  specific  power 
over  the  constitution.  Thus  he  "  surmounted  a  great 
obstacle."  But  soon  there  were  instances  of  those 
who  had  had  true  Cow  Pox  and  yet  received  Small 
Pox  afterwards.  "  This,"  he  adds,  "  like  the  former 
obstacle,  gave  a  painful  check  to  my  fond  and  aspiring 
hopes."  But  he  attributed  It  to  the  possibility  of  a 
milker  being  infected  one  day  and  obtaining  protec- 
tion, while  another  milker  infected  the  next  day  would 
remain  unprotected,  the  matter,  having  lost  its  specifie 
prope7'ties,  producing  sores  and  constitutional  disturb- 
ance, instead  of  the  particular  change  which  was 
necessary  to  render  the  human  l)ody  insusceptible.  This 
observation    ultimately    led    to    the    theory    of   spurious 


EDWARD   'JENNER. 


vaccination.  He  was  struck  with  the  idea  of  propagating 
the  disease  by  inoculation  after  the  manner  of  the  Small 
Pox,  and  he  concluded  by  saying  that  Cow  Pox  was  now 
proved  to  be  a  perfect  security  against  the  Small  Pox  ; 
and  therefore  that  it  was  beyond  the  bounds  of  con- 
troversy, that  the  ultimate  result  of  the  practice  would 
be  the  annihilation  of  the   Small    Pox. 

At  an  early  stage  in  the  history  of  his  observations, 
Jenner  had  hopes  of  his  discovery  proving  a  financial 
success.  Baron,  quoting  from  Jenner's  diary,  has  given 
an  account  of  his  aspirations,  after  his  successful  com- 
munication of  Cow  Pox  to   Phipps. 

"  While  the  vaccine  discovery  was  progressive,  the  joy  I  felt 
at  the  prospect  before  me  of  being  the  instrument  destined  to 
take  away  from  the  world  one  of  its  greatest  calamities,  blended 
with  the  fond  hope  of  enjoying  independence  and  domestic  peace 
and  happiness,  was  often  so  excessive,  that  in  pursuing  my 
favourite  subject  among  the  meadows  I  have  sometimes  found 
myself  in  a  kind  of  reverie." 

Jenner  complained  of  impecuniosity  when  the  Inquiry 
was  published  in  1798,  but  four  years  elapsed  before 
a  claim  for  remuneration  was  laid  before  Parliament. 
He  went  to  London  on  December  9th,  1801,  to  pre- 
pare a  petition,  for  which  he  obtained  the  promise  of 
every  assistance  from   Admiral    Berkeley. 

lUK    HON.    ADMIRAL    BERKKLKV    TO    DR.    JENNER. 

"  Friday  Evening. 
"  Dear  Sir,    -1   have  arranged  everything  with  respect  to  the 
Committee,  and  as  I  find  Mr.  White  was  employed  by  you  to  draw 
up  the  petition,  I  consulted  him  upon  the  best  means  of  conducting 


LIFE  AND   LETTERS. 


173 


it.  He  wishes  to  see  you  with  the  Jicads  of  the  allegations  you 
mean  to  prove,  and  1  have  therefore  desired  him  to  write  to  you 
upon  the  subject,  because  he  will  put  us  in  the  way  of  calling  evi- 
dence with  the  least  inconvenience  ;  as  the  respectable  characters 
who  are  likely  to  appear  w'ill  probably  wish  to  be  kept  as  little  time 
as  possible,  and  of  course  we  ought  to  accommodate  them  as  much 
as  the  nature  of  the  case  will  admit.  If  you  wish  for  any  assist- 
ance which  you  may  think  me  capable  of  affording  before  you  see 
Mr.  White,  I  hope  you  will  believe  you  cannot  afford  me  a  greater 
satisfaction  than  emplo3'ing  me,  being  with  great  truth 

"  Sincerely  yours, 

"  G.  Berkelkv." 

Sir  Henry  Mildmay  also  promised  his  support,  by 
either  laying  his  claim  for  remuneration  before  the 
House  or  seconding  it. 

The  petition  was  drawn  up  and  duly  presented,  March 
I  7th,  1S02. 

The  followino;  were  the  discoveries  alleo-ed  : — 

Firstly.  That  Cow  Pox  was  inoculable  from  cow  to 
man. 

Secondly.  That  persons  so  inoculated  were  for  life 
perfectly  secure  from   Small   Pox. 

Jenner  added  that  he  had  not  made  a  secret  of  his  dis- 
coveries, that  the  progress  of  Small  Pox  had  alread}^  been 
checked,  and  that  he  had  been  put  to  much  expense  and 
anxiety  ;  therefore  he  prayed  for  remuneration. 

"  To   the   Honourable  the  Commons  of  the   United   Kingdom   of 
Great  Britain  and  Ireland,  in   Parliament  assembled. 
"  The  humble  Petition  of  Edward  Jenner,  Doctor  of  Physic, 
"  Sheweth, 

"  That    your   petitioner   having   discovered    tliat   a   disease 


174  EDWARD  JENNER. 

which  occasionally  exists  in  a  particular  form  among  cattle, 
known  by  the  name  of  the  Cow  Pox,  admits  of  being  inocu- 
lated on  the  human  frame  with  the  most  perfect  ease  and  safety, 
and  is  attended  with  the  singularly  beneficial  effect  of  rendering 
through  life  the  persons  so  inoculated  perfectly  secure  from  the 
infection  of  the  Small  Pox. 

"That  your  petitioner  after  a  most  attentive  and  laborious 
investigation  of  the  subject,  setting  aside  considerations  of  private 
and  personal  advantage,  and  anxious  to  promote  the  safety  and 
welfare  of  his  countrymen  and  of  mankind  in  general,  did  not  wish 
to  conceal  the  discovery  he  so  made  on  the  mode  of  conducting 
this  new  species  of  inoculation,  but  immediately  disclosed  the 
whole  to  the  public  ;  and  by  communication  with  medical  men  in 
all  parts  of  this  kingdom,  and  in  foreign  countries,  sedulously 
endeavoured  to  spread  the  knowledge  of  his  discovery  and  the 
benefit  of  his  labours  as  widely  as  possible. 

"  'i'hat  in  this  latter  respect  the  views  and  wishes  of  your 
petitioner  have  been  completely  fulfilled,  for  to  his  high  gratifica- 
tion he  has  to  say  that  this  inoculation  is  in  practice  throughout 
a  great  portion  of  the  civilised  world,  and  has  in  particular  been 
productive  of  great  advantage  to  these  kingdoms,  in  consequence 
of  its  being  introduced,  under  authority,  into  the  army  and  navy. 

"  That  the  said  inoculation  hath  already  checked  the  progress 
of  the  Small  Pox,  and  from  its  nature  must  finally  annihilate  that 
dreadful  disorder. 

"  That  the  series  of  experiments  by  which  this  discovery  was 
developed  and  completed  have  not  only  occupied  a  considerable 
portion  of  3'our  petitioner's  life,  and  have  not  merely  been  a  cause 
of  great  expense  and  anxiety  to  him,  but  have  so  interrupted  him 
in  the  ordinary  exercise  of  his  profession  as  materially  to  abridge 
its  pecuniary  advantages,  without  their  being  counterbalanced  by 
those  derived  from  the  new  practice. 

"  Your  petitioner,  therefore,  with  the  full  persuasion  that  he 
shall  meet  with  that  attention  and  indulgence  of  which 
this  Honourable  House  may  deem  him  worthy,  humbly 
prays  this  Honourable  (louse  to  take  the  premises  into 
consideration,  and  to  grant  him  such  remuneration  as  to 
their  wisdom  shall  seem  meet." 


LIFE  AND  LETTERS.  175 

The  kinf^'s  pleasure  was  taken  on  ihe  contents  of  the 
petition,  and  his  Majesty  recommended  it  to  Parha- 
ment.  It  was  referred  to  a  Committee,  presided  over 
by  Admiral  Berkeley,  and  in  June  1802,  the  Report 
was  laid  before  the  House.  Admiral  Berkeley  moved 
for  a  grant  of  ^10,000,  which  was  duly  seconded  by 
Sir  Henry  Mildmay,  and  carried  by  a  majority  of 
three.  After  the  conclusion  of  the  Parliamentary 
inquiry,  Jenner  left   London  for   Berkeley. 

Once  more,  he  had  leisure  to  attend  to  his  corre- 
spondence on  the  constant  subject  of  failures  of  Cow 
Pox  to  j^rotect  from   Small   Pox. 

To  R.   Dunning,   Esq. 

"  1802. 

"  My  Dear  Sir, — Our  last  letters  crossed  each  other  on  the 
road,  according  to  custom.  Your  letter  of  April  the  22nd  reached 
me  at  a  time  when  my  head  was  brimful  of  the  bustles  of  the 
Committee,  and  was  not,  I  think,  sufficientl}',  at  least  properly, 
noticed  in  any  subsequent  letter  of  mine.  What  I  allude  to  is 
your  account  of  the  inoculation  of  iVIr.  Courtney,  Mr.  Yonge,  and 
the  staggering  cases  of  yourself  and  Mr.  Lisle.  Add  to  this,  the 
case  of  the  marine  at  Portsmouth.  Now,  my  good  friend,  my 
mind  having  long  since  obtained  what  security  it  is  capable  of 
possessing,  I  request  of  you  to  tell  me  what  time  and  enquiry 
have  developed  respecting  these  Pl3^mouth  cases.  That  of  the 
marine  at  Portsmouth  was  clearly  made  out  to  have  been 
imperfect.  The  people  at  this  sea-port  set  up  a  kind  of 
malignant  shout  (see  the  Letters  of  Hope  in  the  Report  of 
the  Committee)  at  finding  this  case  of  supposed  failure.  They 
disliked  vaccination  because  Plymouth  adopted  it;  taiita  est  dis- 
cordia  fratrum. 

"  Mr.  Bankes,  who  drew  up  the   Report,   was  no  friend   either 


1-6  EDJVARD   JENNKR. 


to  me  or  mv  cause,  or  he  would  have  listened  to  m}-  solicitations, 
and  inserted  not  only  the  certificates  you  mention,  but  your  letter 
also.  Let  any  one  read  the  Report  of  Dr.  Smith,  and  compare 
it  with  mine ;  then  let  them  judge  who  had  indulgences  and  who 
had  none.  The  indisposition  of  my  chairman,  Admiral  Berkeley, 
was  a  most  unfortunate  event.  The  whole  merit  Mr.  Bankes 
allowed  me  on  the  score  of  discover}^  in  vaccination  (considering 
it  abstractedly)  was  that  of  inoculating  from  one  human  being  to 
another.  On  this  subject  I  remonstrated,  but  it  was  all  in  vain. 
Cannot  you  contrive  to  get  your  papers  into  the  Journal  ?  Surely 
you  might  command  m}'  assistance  whenever  3'ou  please  ;  the}' 
would  gain  admittance  with  the  most  perfect  propriety  in  reply 
to  Pearson's  audacious  assertion,  and  produce  good  effects  in  a 
variety  of  ways." 

After  his  return  to  Berkeley,  several  friends  in  London 
resolved  to  endeavour  to  form  a  Jennerian  Institution  for 
promoting  universal  vaccine  inoculation.  On  January 
19th,  1803,  a  public  meeting  was  convened  and  presided 
over  by  the  Lord  INLiyor.  It  was  proposed  and 
seconded,  "  that  this  meeting  do  form  itself  into  a 
society  for  the  extermination  of  the  Small  Pox." 
It  happened  that  his  Royal  Highness  the  Duke  of 
Clarence  was  prepared  to  move,  by  deputy,  a  vote  of 
thanks  to  Dr.  Jenner.  vSo  it  was  immediately  resolved 
that  th(;  Duke  of  Clarence  should  entreat  his  Majesty 
to  become  patron  of  the  proposed  institution,  and  grant 
permission  for  it  to  be  called  the  Royal  Jennerian 
Society  for  the  extermination  of  the  Small  Pox.  His 
Majesty  graciously  consented,  the  Queen  became  patron, 
and  other  royal  personages  vice-patrons ;  many  ladies 
of    rank    als(j    were    induced    to    interest    themselves    in 


LIFE  AND  LETTEK\S.  177 


supporting  vaccination.  A  board  of  directors  and 
a    medical    council    were    appointed. 

Jenner  remained  at  Berkeley  until  February  1803,  when 
he  went  to  London.  On  the  3rd  of  this  month,  he  took  his 
seat  for  the  first  time,  as  President  of  the  Royal  Jennerian 
Institution.  At  a  subsequent  meeting,  Dr.  John  Walker 
was  appointed  resident  inoculator.  Thirteen  stations 
were  opened  in  the  Metropolis,  and  in  eighteen  months 
they  were  able  to  announce  that  12,288  inoculations 
had  taken  place,  and  19,352  charges  of  Cow  Pox  virus 
supplied  to  different  parts  of  the  British  Empire  and  to 
foreign  countries.  Events,  however,  did  not  continue 
to  run  smoothly.  Jenner  disapproved  of  Dr.  Walker, 
and  used  all  his  influence  to  obtain  his  dismissal,  which 
led  to  Dr.  Walker's  resigning  his  office.  The  Society 
lingered  on  for  some  time,  but  when  the  National 
Vaccine  Institution  was  established  in  1808,  its  finances 
were  nearly  exhausted,  and  it  had  practically  collapsed. 

Shortly  after  the  formation  of  the  Royal  Jennerian 
Institution,  Jenner  was  induced  to  take  up  practice  in 
London.  He  settled  for  some  years  in  Hertford 
Street,   INIayfair,  but  the  result  was  disastrous. 

He  therefore  determined  to  leave  London,  and  com- 
municated his  intention  to  one  of  his  friends. 

"  I  have  now  completely  made  up  my  mind  respecting  London. 
I  have  done  with  it,  and  have  again  commenced  the  village-doctor. 
I  found  my  purse  not  equal  to  the  sinking  of  a  thousand  pounds 
annually  (which  has  actually  been  the  case  for  several  successive 
years),  nor  the  gratitude  of  the  public  deserving  such  a  sacrifice. 

VOL.   I.  12 


178  EDWARD  JENNER. 


How  hard,  after  what  I  have  done,  the  toils  I  have  gone  through, 
and  the  anxieties  I  have  endured  in  obtaining  for  the  world  a 
greater  gift  than  man  ever  bestowed  on  them  before  (excuse 
this  burst  of  egotism),  to  be  thrown  by  with  a  bare  remuneration 
of  my  expenses  !  " 

Ten  years  afterwards,  Jenner  gave  a  detailed  account 
of  his  experiences. 

"  Elated  and  allured  by  the  speech  of  the  Chancellor  of  the 
Exchequer,  I  took  a  house  in  London  for  ten  years,  at  a  high 
rent,  and  furnished  it ;  but  my  first  year's  practice  convinced  me 
of  my  own  temerity  and  imprudence,  and  the  falsity  of  the  minis- 
ter's prediction.  My  fees  fell  off  both  in  number  and  value ;  for, 
extraordinary  to  tell,  some  of  those  families  in  which  I  had  been 
before  employed,  now  sent  to  their  own  domestic  surgeons  or 
apothecaries  to  inoculate  their  children,  alleging  that  they  could 
not  think  of  troubling  Dr.  Jenner  about  a  thing  executed  so  easily 
as  vaccine  inoculation.  Others,  who  gave  me  such  fees  as  I 
thought  myself  entitled  to  at  the  first  inoculation,  reduced  them 
at  the  second,  and  sank  them  still  lower  at  the  third." 

In  the  year  1804,  failures  of  the  new  inoculation  had 
multiplied  to  an  alarming  degree,  and  even  some 
of  his  friends  began  to  lose  confidence.  His  time  was 
again  much  taken  up  in  correspondence,  suggesting 
fresh  explanations  to  account  for  the  numerous  failures. 

Nevertheless,  some  of  Jenner's  friends  were  of  opinion 
that  this  year  formed  a  new  era  in  the  history  of 
Cow  Pox,  for,  according  to  Baron,  if  the  assertion  that 
Cow  Pox  afforded  only  a  temporary  security  had 
been  correct,  it  would  have  deprived  the  discovery  of 
nearly  all  its  value.  Jenner  had  conceived  that  in  cases 
ol    Small    Pox  occurring  after  Cow  Pox,  the  vaccination 


LIFE  AND  LETTERS.  179 


could  not  have  been  properly  performed ;  but  Mr. 
Dunning  endeavoured  to  establish  a  belief  in  the 
permanent  protection  of  Cow  Pox,  by  explaining 
failures  as  the  result  of  spurious  vaccination.  In  the 
course  of  the  same  year,  Jenner  published  his  tract 
on  the  Varieties  and  Modifications  of  the  Vaccine 
Pustnle,  occasioned  by  a  State  of  the  Skin,  which  had 
the   same   end   in   view. 

Jenner,  however,  was  fully  aware  that  Small  Pox  had 
occurred  after  perfect  vaccination,  and  in  his  cor- 
respondence with  Mr.  Dunning,  he  was  prepared 
with  various  answers  to  meet  these  cases,  though, 
at  the  same  time,  he  endeavoured  to  i'suppress  their 
publication, 

"  I  have  just  received  the  Portsmouth  paper  of  the  2nd  of 
April,  sent  to  me,  I  suppose,  by  the  printer.  It  contains,  in 
large  letters,  the  following  sensible  paragraph  :  '  Reports  of  some 
cases  of  Small  Pox  after  vaccine  inoculation  were  read  at  a  very 
full  meeting  of  the  Medical  Society  of  Portsmouth  on  Thursday 
last  the  29th  instant,  which  we  are  informed  will  be  sent  to  the 
press,  and  published  in  a  few  days.'  Is  Dr.  Hope  returned 
to  his  old  post  ?  What  a  set  of  blockheads  !  How  will  our 
continental  neighbours  laugh  at  us  ! " 

His  explanations,  however,  were  ready  to  hand, 
when  he  was  applied  to.  Thus  he  wrote  to  Lord 
Berkeley  : — 

"  I  expect  that  cases  of  this  sort  will  flow  in  upon  me  in  no 
inconsiderable  numbers ;  and  for  this  plain  reason — a  great 
number,  perhaps  the  majority,  of  those  who  inoculate  are  not 
suflicientiy   acquainted   with    the  nature  of  the  disease  to  enable 


EDWARD  JENNER. 


them  to  discriminate  with  due  accuracy  between  the  perfect 
and  imperfect  pustule.  This  is  a  lesson  not  very  difficult  to  learn, 
but  unless  it  is  learnt,  to  inoculate  the  Cow  Pox  is  folly  and 
presumption." 

Another    correspondent    pleaded    with  him    to    reply 

to   the  writings    of   those   who    opposed  the  Jennerian 

doctrine,  the  so-called  anti-vaccinists.  But  Jenner 
declined  to  enter  into  the  controversy. 

"The  post  is  just  come  in,  and  I  have  been  entertaining  Mrs. 
Jenner  and  my  family  with  your  dream.  Some  kind  friend  had 
perhaps  thrown   your  stomach  into  disorder  by  tempting  you  to 

go  too  deep  into  an  oyster-barrel ;  or  had  our  friend  P seduced 

you  with  the  fumes  of  one  of  his  favourite  supper  dishes  ?  A 
devil,  or  a  something,  had  certainly  disordered  your  stomach  ;  and 
your  stomach  shewed  its  resentment  on  your  head  ;  and  your 
letter  is  the  consequence.  However,  I  will  reason  on  it  for  a 
moment  as  if  it  were  not  a  dream.  You  are  imposed  upon,  and 
so  is  my  friend  Fox.  Vaccination  never  stood  on  more  lofty 
ground  than  at  present.  1  know  very  well  the  opinion  of  the 
wise  and  great  upon  it ,  and  the  foolish  and  the  little  I  don't  care 
a  straw  for.  Why  should  we  fix  our  eyes  on  this  spot  only  ? 
Let  them  range  the  world  over,  and  they  must  contemplate  with 
delight  and  exultation  what  they  behold  on  the  great  continents 
of  Europe  and  America ;  in  our  settlements  in  India,  where  all 
ranks  of  people,  from  the  poor  Hindoo  to  the  Governor-General, 
hail  Vaccina  as  a  new  divinity.  In  the  island  of  Ceylon,  my 
account  states  that  upwards  of  thirty  thousand  had  been  vaccinated 
a  twelvemonth  ago.  1  could  march  you  round  the  globe,  and 
wherever  you  rested  you  should  see  scenes  like  these.  There 
1  have  honour,  here  I  have  none :  and  let  me  tell  you,  whatever 
my  feelings  may  have  been  on  this  subject,  they  are  now  at  rest. 
What  I  have  said  on  this  vaccine  subject  is  true.  If  properly  con- 
ducted^ it  secures  the  constitution  as  much  as  variolous  inoculation 
possibly  can.  It  is  the  Small  Pox  in  a  purer  form  than  that  which 
has  been  current  among  us  for  twelve  centuries  past." 


LIFE  AXD  LF.TTERS. 


"  You  and  my  city  friend  suppose  me  idle — that  I  no  longer 
employ  my  time  and  my  thoughts  on  the  vaccine  subject.  So 
very  opposite  is  the  real  state  of  the  case,  that  were  you  here 
(where  I  should  be  very  glad  to  see  you),  you  would  see  that 
my  whole  time  is  nearly  engrossed  by  it.  On  an  average  I  am 
at  least  six  hours  daily  with  my  pen  in  my  hand,  bending  over 
writing-paper,  till  I  am  grown  as  crooked  as  a  cow's  horn  and 
tawny  as  whey-butter;  and  you  want  to  make  me  as  mad  as  a 
bull  :  but  it  won't  do,  Mr.  D. ;  so  good-night  to  you.  I'll  to  my 
pillow,  not  of  thorns,  believe  me,  nor  of  hops ;  but  of  poppies,  or 
at  least  something  that  produces  calm  repose." 

Jenner  had  constantly  to  resort  to  the  theory  that 
if  Small  Pox  occurred  after  Cow  Pox,  the  vaccination 
could   not   have  been   properly   performed. 

Dr.  Jenner  to  Mr.  Dunning. 

"  ^u/y  '^th,  1804. 

"There  is  not  a  single  case,  nor  a  single  argument,  that  puts 
the  weight  of  a  feather  in  the  scale  of  the  anti-vaccinist.  That 
which  seems  to  be  the  heaviest,  becomes  light  as  air,  when  we 
consider  that  the  human  constitution  is  at  one  time  susceptible 
of  variolous  contagion,  at  another,  not  so ;  and  this  insuscepti- 
bility sometimes  continues  to  a  late  period  of  life.  Elizabeth 
Everet  was  a  Small  Pox  nurse  in  this  neighbourhood  for  forty 
years.  She  supposed  she  had  had  the  Small  Pox  when  a  child. 
A  few  years  since  she  was  sent  for  to  Bristol  to  nurse  a  patient, 
caught  the  disease,  and  died. 

"  Mr.  Long,  surgeon  of  St.  Bartholomew's,  had  a  similar 
instance  in  his  own  family. 

"  A  thousand  thanks  to  you  and  Dr.  Remmet  for  your  inves- 
tigation of  the  Exmouth  case.  Never  mind ;  you  will  hear 
enough  of  Small  Pox  after  Cow  Pox.  It  must  be  so.  Every 
bungling  vaccinist  who  excites  a  pustule  on  the  arm,  will  swear 
like  G.  it  was  correct,  without  knowing  that  nicety  of  distinction 
which  every  man  ought  to  know,  before  he  presumes  to  take 
up  the  vaccine  lancet." 


i82  EDWARD  JENNER. 


But  even  after  perfect  vaccination,  it  was  well  known 
that  after  a  little  time,  patients  could  be  infected  by 
inoculation.  To  meet  this,  Jenner  urged  that  the 
inoculation   test   should  be  abandoned.^ 

"  Had  vaccination  wanted  firmer  support  than  it  has  ah-eady, 
it  would  have  obtained  it  from  the  very  efforts  made  use  of  for 
its  destruction.  I  will  just  remark  that  the  fairest  of  all  tests 
is  exposure  to  variolous  contagion ;  this  is  the  natural  test, 
inoculation  is  not.  Who  does  not  know  (all  medical  men  ought 
to  know)  that  the  insertion  of  the  variolous  poison  into  the  skin 
of  an  irritable  person  will  sometimes  produce  great  inflammation, 
disturbance  of  the  sj'stem,  and  even  eruptions  ? 

"  Adieu,  my  dear  sir.     I  write,  as  you  must  observe,  in  haste. 

"  Yours  truly, 

"  E.  Jenner. 

"  Just  setting  off  with  my  family  to  Cheltenham. 

"  P.S.  I  am  sorry  to  say  I  cannot  send  you  advertisements 
to  the  cover  of  the  Medical  Journal.  The  review  of  G.'s  book 
will  teU  you  I  have  no  interest  there." 

Mr.  Dunning  himself  encountered  failures,  and  his 
fiith  in  vaccination  was  fast  disappearing.  He  conse- 
quently  was   severely  reprimanded — 

"  Vaccination  calls  imperiously  for  my  attention,  and  to  that 
I  am  determined  all  my  other  worldly  concerns  shall  yield. 
But  while  I  am  fighting  the  enemy  of  mankind,  it  will  be 
vexatious  to  see  my  aides-de-camp  turn  shy.  Among  the 
foremost  in  the  field,  I  have  always  ranked  Richard  Dunning. 
No  one  has  been  more  obedient  to  the  commands  of  his  general, 
or  wielded  the  sword  against  the  foe  with  greater  force  and 
dexterity.  But  shall  I  live  to  see  my  friend  dismayed  at  the 
mere  shadow  of  fortune  on  the  side  of  the  enemy; — will  he 
who  has  led  such  hosts  into  the  field  and  found  them  invulnerable, 

'  Extract  from  letter  to  R.  Dunning-.     Baron,  loc.  cit.,  vol.  ii,,  p.  339. 


LIFE  AND  LETTERS.  183 

start  if,  in  the  continuation  of  tlie  combat,  he  sliouid  see  a  man 
fall  ?  Enough  of  metaphor.  The  moral  of  all  this  is,  that 
I  see  you  are  growing  timid  ;  the  timidity  so  conspicuous  towards 
the  close  of  your  pamphlet,  and  that  which  is  so  manifest  in 
your  letter  of  this  evening,  it  would  be  wrong  in  me  not  to  say 
I  was  sorry  to  observe.  More  convincing  or  stronger  facts 
the  public  could  never  wish  for  than  your  pamphlet  exhibits. 
Had  I  been  at  your  elbow,  I  should  have  certainly  pulled  back 
your  pen  when  you  began  reasoning  upon  them.  The  result 
of  your  experiments  authorised  you  to  speak  in  tones  the  most 
exulting  and  triumphant  ;  but  most  unfortunately,  you  almost 
give  up  the  field  to  the  anti-vaccinists,  by  speaking  of  new  and 
better  arrangements,  if  variolous  inoculation  should  supersede  the 
vaccine!  Now,  my  good  and  valued  friend,  don't  for  a  moment 
think  that  I  am  out  of  temper  with  you,  or  mean  to  speak 
harshly.  On  the  contrary,  I  attributed  this  oversight  (such  I  must 
call  it)  to  the  dreadful  calamity  that  befell  your  family.  Your 
mind,  I  know,  must  have  been  oppressed,  and  you  were  bringing 
3'our  work  to  a  conclusion  under  pressures  scarcely  bearable. 
To  those  who  made  remarks  upon  what  appeared  so  extra- 
ordinar}',  I  communicated  the  circumstance  which  seemed  to 
me  to  account  for  it.  The  115th  page  of  your  work,  is  that 
which  has  occasioned  the  general  surprise.  The  further  I  go 
on  with  vaccination,  the  more  I  am  convinced  that  the  great 
and  grand  impediment  to  the  correct  action  of  the  virus  on  the 
constitution,  is  the  co-existence  of  herpes.  I  expected  that  my 
paper  on  this  subject,  in  the  Medical  Journal  for  August,  would 
have  attracted  more  attention.  Since  my  writing  it,  I  have 
detected  a  case  of  Small  Pox  after  Small  Pox  inoculation,  where 
the  cause  of  failure  w-as  evidently  an  herpetic  affection  of  the 
scalp.  Are  such  cases  as  these — are  such  as  Mr.  Embling, 
so  circumstantially  described  in  your  pamphlet — are  Mr.  Tyre's 
lately  communicated  in  the  Star — are  Mr.  Kite's  of  Gravesend, 
and  a  thousand  others,  to  go  unnoticed  by  the  public,  while 
failures  in  vaccination  (a  science  far  more  difficult  to  understand 
than  variolation)  are  to  make  impressions  so  deep  as  even 
to  stagger  the  faith  of  those  who  are  well  informed  upon  the 
subject?      Is   common   sense   to   be   attached    to  one  side  of  the 


EDWARD  JENNER. 


question  only,  and  to  have  nothing  to  do  with  the  other  ?  '  This 
case,  connected  with  those  in  London  at  Fullwoods  Rents, 
I  grieve  to  say,  appear  extremely  ugly.' — Dunning. 

*'  Is  it  possible  their  ugHness  can  affright  you  ?  What 
phantoms  must  they  appear,  if  you  will  but  look  back  and 
consider  the  period  when  those  children  were  inoculated.  Wood- 
ville  at  that  time,  and  his  coadjutor  Wachsel  knew  nothing 
of  the  Cow  Pox ;  this  is  clearly  evinced  by  Woodville's  first 
pamphlet,  where  he  gives  three  hundred  cases  of  Small  Pox, 
and  calls  them  Cow  Pox.  Surely  his  early  inoculations  are 
not  to  be  regarded ;  and  does  he  not  at  this  hour,  in  conjunction 
with  a  person  whose  dirty  name  shall  not  daub  my  paper,  sanction 
the  taking  of  virus  from  the  pustule  at  any  of  its  stages  ?  What 
are  we  to  expect  while  such  things  as  these  are  going  forward  ? 
Inclosed  is  the  letter  you  requested  me  to  return  ;  it  is  impossible 
for  me  to  go  into  particulars  on  such  cases.  I  can  only  go 
into  general  reasoning.  My  experience  justifies  me  in  saying 
that  which  I  have  said  fifty  times  before,  '  If  the  vaccine  pustule 
goes  through  its  stages  correctly,  the  patient  is  secure  from 
the  Small  Pox ;  if  not,  security  cannot  be  answered  for.'  There 
certainly  is  sometimes  a  nicety  in  discrimination,  and  it  was 
this  which  in  my  early  instructions  occasioned  me  to  say, 
'  When  a  deviation  arises  in  the  character  of  the  vaccine 
pustule,  of  whatever  kind  it  may  be,  common  prudence  points 
out  the  necessity  of  re-inoculation.'  Cases  may  possibly  occur, 
where  even  30U  or  I  may  (from  the  interposition  of  those  events 
which  medical  men  are  always  subject  to)  not  have  it  in  our 
power  to  catch  opportunities  of  passing  our  judgment  upon 
a  pustule  during  those  stages,  whether  it  is  or  is  not  correctly 
defined.  With  respect  to  the  doctrine  of  Mr.  Moyle,  I  must 
candidly  say,  my  experiments  do  not  justify  me  in  subscrib- 
ing to  them.  Be  of  good  cheer,  my  friend.  Those  who  are  so 
presumptuous  as  to  expect  perfection  in  man  will  be  grievously 
disappointed.  His  works  are  and  ever  will  be  defective.  Let 
people,  if  they  choose  it,  spurn  the  great  gift  that  heaven  has 
bestowed,  and  turn  again  to  variolation.  What  will  they  get 
by  it  ?  Let  them  consult  pages  6y  and  68  of  your  decisive 
work  on  this  subject,   and   they    will    know.      Let    them    peruse 


LIFE  AND  LETTERS.  i8s 


the  following  extract  from  a  letter  '  which  1  have,  within  these 
few  days,  received  from  a  medical  gentleman  of  great  respectability 
in  this  county.  '  A  poor  family  belonging  to  Sudeley  parish, 
consisting  of  a  man,  his  wife,  and  five  children,  were  vaccinated 
four  or  five  years  ago,  except  the  eldest  daughter,  who  had 
been  before  inoculated  for  the  Small  Pox  by  an  eminent 
practitioner,  and  pronounced  secure.  This  summer  she  caught 
the  Small  Pox  when  working  among  the  rags  at  the  paper 
mills,  and  had  a  very  numerous  and  confluent  eruption.  The 
rest  of  the  family  have  no  fears,  and  have  all  escaped,  though 
fully  exposed  to  the  infection.'  Now  had  this  case  been 
reversed,  what  a  precious  morsel  it  would  have  been  for  an 
anti-vaccinist.  Adieu  my  dear  friend,  and  be  assured  of  the 
unalterable  regard  of  yours, 

"  Edw\  Jenner. 

For  a  time  the  letter  had  the  desired  effect  upon 
Mr.  Dunning,  and  it  was  soon  followed  by  another,  in 
which  flattery  was  employed  to  smooth  his  ruffled 
feelings. 

To  Richard  Dunning,  Esq.,  Plymouth, 

"Cheltenham,  x'-^th  Nov.  1804. 

"  My  Dear  Sir, — The  old  occurrence  of  our  letters  crossing 
on  the  road  has,  1  see,  again  taken  place.  If  my  writing 
frequently  to  you  will  afford  you  the  least  gratification,  I  shall 
not  be  slack  in  my  correspondence. 

"  Inhere  is  no  one  more  entitled  to  my  attention,  and  among 
all  the  vaccinists  Vv^ho  have  enlisted  under  my  banner,  there 
is  no  one  who  has  a  greater  claim  for  my  regard.  There  was 
no  expression  in  my  letter,  I  hope,  which  would  bear  the  con- 
struction you  seem  to  put  upon  it.  You  were  rallied  a  little 
on  your  timidity  respecting  the  ugly  cases  in  town  and  country 
— on  your  glancing  at  a  better  regulation  for  the  management 
of  the  Small  Pox,  if  we  are  obliged  to  turn  to  it  again — on  your 
fear  of  reviews— and  of  a  little  shrinking,  even,  from  the  man 
whom   you   are   opposing ;   but    all    was    done    in    perfectly    good 


1 86  EDWARD    JFNNER. 


humour,  and  now  you  will    allow  me    triumphantly    to    exclaim, 
*  Richard's  himself  again  ! '  " 

Dunning  was  now  ready  to  assert  that  the  occurrence 
of  Small  Pox  after  Cow  Pox,  actually  strengthened  the 
theory.      Even  Jenner  was  puzzled  and  wrote  :— 

"  Pray  indulge  me  with  a  line  or  two  very  speedily,  to  put 
an  end  to  a  little  perplexity.  You  tell  me  that  you  know  Small 
Pox  will  sometimes  follow  Cow  Pox,  and  nevertheless  assert 
that  a  case  of  this  sort,  which  has  happened  under  your  immediate 
observation,  places  vaccination  on  higher  ground  than  it  has 
yet  stood   on. 

"  Do  pray  explain,  as  soon  as  you  can,  your  meaning.  .  .  . 

"  I  am.  pleased  at  seeing  the  friends  of  the  vaccine  cause 
showing  themselves  in  the  newspapers.  These  meet  every  eye, 
while  the  Journal  meets  that  of  medical  men  only,  and  has 
proved  the  tomb  of  many  an  impressive  paper." 

But  Dunning  was  not  yet  completely  subdued,  for  in 
a  work  which  he  wrote  on  vaccination,  he  was  still 
willing  to  discuss  doubtful  cases.  Jenner  commended 
the  pamphlet  as  a  whole,  while  insisting  upon  the 
necessity  for  collecting  all  evidence  in  favour  of 
vaccination  and  rejecting  all  criticism. 

To  R.   Dunning,   Esq. 

"  Berkeley,  Feb.  \oth,  1805. 
"  My  Dear  Friend, — Your  little  pamphlet  contains  many 
great  and  useful  observations.  I  will  now  refer  you  to  a  few 
notes  I  made  in  perusing  it.  The  book  itself  should  have  been 
printed  in  the  more  general  shape  and  form  of  pamphlets. 
Page  16,  concluding  sentence  of  the  first  paragraph,  pithy,  and 
containing  a  complete  reply  to  the  anti-vaccinists,  who  may 
urge   objections  from    a    few    solitary    cases    of   Small   Pox   after 


LIFE  AND  LETTERS.  187 


Cow  Pox,  or  who  might  bring  them  forward  if  they  were  ten 
times  as  numerous.  100,000  cases  of  vaccination,  by  far 
too  few  to  calculate  upon.  Half  that  number  I  can  reckon 
from  extra-professional  inoculations,  20,000  of  which  are  from 
my  fair  disciples  ;  and,  to  their  credit  be  it  spoken,  I  have 
not  heard  of  one  sinister  event  among  this  class  of  inoculations. 
And  why?  They  implicitly  obey  vaccine  laws.  Page  12, 
good  reasoning  on  the  subject  of  population.  I  have  often 
urged  the  following  argument  when  too  numerous  a  population 
has  been  thrown  in  my  teeth,  as  one  of  the  ill  effects  likely  to 
attend  vaccination.  .  .  . 

**  Your  manner  of  speaking  of  Goldson  increases  his  arrogance. 
He  obstinately  holds  the  veil  before  his  eyes,  and  will  not 
behold  the  vaccine  light.  I  am  about  to  make  a  stronger  pull 
at  this  veil  than  has  been  done  yet.  I  have  sent  him  an 
invitation  to  visit  me  at  Berkeley,  or  to  appoint  a  deputation 
from  the  Medical  Society  at  Portsmouth  ;  I  have  gone  further 
(perhaps  too  far),  I  have  almost  pledged  my  word  that  his 
conversion  will  be  the  consequence  of  the  interview.  The  fact 
is,  he  is  totally  ignorant  of  that  wise  discriminating  power, 
without  which  no  man  can  be  a  perfect  vaccinist :  and  it  is  my 
wish  to  impart  it  to  him.  One  might  as  well  contend  with 
a  blind  man  on  the  nature  of  the  prism,  as  with  a  person  in 
this  situation,  and  entertain  a  hope  of  being  successful ;  but  to 
proceed.  In  another  edition,  pray  take  in  Kite's  cases  of  Small 
Pox  after  Small  Pox  inoculation.  They  are  the  more  forcible 
as  they  were  published  antecedent  to  the  vaccine  practice. 
Page  38.  Are  you  sure  the  pustule  was  variolated?  Page  41. 
I  do  not  see  the  necessity  for  your  parenthesis.  Perhaps  my 
feelings  are  too  acute,  but  I  do  not  like  to  see  my  darling  child 
whipped  even  with  a  feather.  In  your  postscript,  why  not 
ask  for  cases  of  Small  Pox  after  Small  Pox  inoculation,  as  well 
as  cases  of  Small  Pox  after  vaccination." 

On  March  ist,  we  find  Jenner  again  writing  on 
failures  ;  this  shows  how  much  his  mind  was  occupied 
with   them   at  this   time. 


'EDWARD  JENNER. 


"The  security  given  to  the  constitution  by  vaccine  inoculation, 
is  exactly  equal  to  that  given  by  the  variolous.  To  expect  more 
from  it  would  be  wrong.  As  failures  in  the  latter  are  constantly 
presenting  themselves,  nearly  from  its  commencement  to  the 
present  time,  we  must  expect  to  find  them  in  the  former  also. 
In  my  opinion,  in  either  case,  they  occur  from  the  same  causes  ; 
one  might  name  for  example,  among  others,  some  peculiarity 
of  constitution  which  prevents  the  virus  from  acting  properly, 
even  when  properly  applied ;  from  inattention,  or  want  of  due 
knowledge  in  the  inoculator ;  particularly  in  not  being  able  to 
discriminate  between  the  correct  and  incorrect  pustule." 

Dunning  wrote  disapproving  of  the  policy  of  setting 
off  cases  of  Small  Pox  after  Small  Pox,  against  those 
of  Small   Pox  after  Cow   Pox.       Jenner  replied  : — 

"  Think  a  moment  of  my  situation  before  you  censure  me  for 
tardiness — the  correspondence  of  the  world  to  attend  to.  The 
pressure  is  often,  I  do  assure  you,  so  great,  that  it  is  more  than 
either  my  body  or  mind  can  well  endure.  You  say,  '  let  vacci- 
nation, for  God's  sake,  rest  on  its  own  foundation.'  My  dear  sir, 
that  is  exactl}^  what  I  want,  and  the  course  I  have  been  pursuing. 
Neither  the  impudence  of  Pearson,  the  folly  of  Goldson,  nor  the 
baseness  of  Moseley  and  Squirrel,  to  which  I  may  add  the  stupid 
absurdity  of  Birch,  has  put  me  out  of  my  way  in  the  least, — and 
why  ?  I  placed  it  on  a  rock,  where  I  knew  it  would  be 
immoveable,   before  I  invited  the  public  to  look  at  it." 

Some  time  afterwards,  Dunning  appears  to  have 
spoken  out  freely.       Jenner  replied: — 

"  A  pretty  sharp  philippic,  my  good  friend  !  but  in  such 
veneration  do  I  hold  the  man  of  feeling,  that  if  it  had  been 
ten  times  as  sharp,  I  should  have  read  it,  though  not  without 
emotion,  yet  certainly  without  a  murmur.  Allow  me  just  to 
make  one  observation.     Should  anything  like  the  present  occur- 


LIFE  AND  LETTERS. 


rence  ever  happen  again,  let  me  entreat  you  not  to  indulge  for 
a  moment  a  fanciful  speculation  against  your  ftiend.  As  such  I 
hope  ever  to  be,  and  so  to  be  considered  by  you."    • 

Jenner  continued  to  collect  cases  of  Small  Pox  after 
Small  Pox.  and  wrote  for  assistance  to  his  friend, 
the   Rev.   John   Clinch,   Trinity,   Newfoundland. 

"  Never  aim,  my  friend,  at  being  a  public  character,  if  you  love 
domestic  peace.  But  I  will  not  repine.  Nay,  I  do  not  repine, 
but  cheerfully  submit,  as  I  look  upon  myself  as  the  instrument  in 
the  hands  of  that  power  which  never  errs,  of  doing  incalculable  good 
to  my  fellow-creatures.  You  would  do  me  an  essential  kindness 
in  acquainting  me  with  the  state  of  vaccination  in  your  island,  as 
I  shall  appear  again  before  the  House  of  Commons  next  session, 
and  I  am  collecting  all  the  information  I  can  from  foreign  parts. 
Write  to  me  not  as  if  your  letter  was  to  be  shown  to  the  House 
of  Commons,  and  detail  the  real  state  of  facts  relative  to  the 
benefits  derived  from  the  new  practice.  Remember  me  kindly 
to  Mrs,  Clinch,  and  my  old  friend  Edward,  who  I  ardently  hope 
is  becoming  useful  to  you  ;  and  believe  me,  dear  Clinch,  ever 
truly,  and  sincerely  yours, 

"  Edw.  Jenner. 

"  Do  you  recollect  any  cases  of  persons  catching  the  Small  Pox 
after  the  Small  Pox,  either  after  casual  contagion,  or  inoculation  ? 
I  have  collected  a  great  number  of  such  cases,  but  want  more." 

We  may  now  turn  our  attention  for  a  moment  to 
London.  In  the  same  year,  1805,  a  paper  appeared 
in  the  Gentleman s  Magazine,  "  the  only  publication 
that  then  would  venture  to  insert  anything  adverse  to 
the  Vaccine  System."  This  paper  had  been  written 
by   Birch, ^    in    1804,   and  circulated   among   his    intimate 

'  John  Birch,  Surg'eon  Extraordinary  to  His  Royal  Highness  the  Prince 
of  Wales,  and  Surgeon  of  St.  Thomas's  Hospital. 


[go  EDWARD  JENNER. 


friends,  in  vindication  of  the  opinion  which  he  had 
given  before  the  Committee  of  the  House  of 
Commons.  Birch  condemned  vaccination  as  an 
unnatural    experiment,    unphilosophical,    and    unsafe, 

"  Magna  est  Veritas  et  pr^valebit. 

"  Had  the  Inoculation  for  what  has  been  called  Cow  Pox 
succeeded,  agreeably  to  the  sanguine  promises  and  expectations 
of  its  advocates,  I  should  have  thought  myself  called  upon  to 
recant  the  opinion  I  gave  to  the  Committee  of  the  House  of 
Commons,  and  to  apologize  for  having  persevered  in  it ;  but  as 
the  experiment  has  failed  in  several  instances,  and  the  truth  can 
no  longer  be  concealed  from  the  public,  I  think  it  necessary  to 
appeal  to  the  judgment  of  discerning  persons,  whether  I  have  not 
been  treated  with  much  injustice,  for  firmly  maintaining  an  opinion 
for  which  I  had  such  strong  grounds, 

"  It  was  a  maxim  handed  down  to  us  while  I  was  a  Student  at 
St.  Thomas's  Hospital,  '  Never  to  sacrifice  Experience  to  Experi- 
ment ;'  and  therefore  in  Diseases,  for  the  treatment  of  which  Time 
and  Observation  had  laid  down  a  rule  of  successful  practice,  I  am 
cautious  how  I  exchange  this  for  new  opinions. 

"  The  judicious  manner  in  which  my  excellent  friend,  Baron 
Dimsdale,  managed  the  Inoculation  for  Small  Pox,  had  long  con- 
vinced me  that  if  any  man  deserved  well  of  his  Country,  he  was 
entitled  at  least  to  the  thanks  of  the  Legislature;  and  the  oppor- 
tunities I  had  of  making  myself  acquainted  with  his  opinions, 
taught  me  to  listen  with  caution  to  any  new  practice,  which  was 
to  overturn  all  I  had  made  myself  master  of. 

'*  When  therefore  it  was  proposed  to  me,  to  introduce  a  neiu 
Disease  into  tlic  huuian  system,  I  hesitated;  but  on  the  assurance 
given  to  me,  that  it  was  still  milder  than  the  Inoculated  Small 
Pox,  was  productive  of  no  ill  consequences,  and  would  equally 
arrest  the  progress  of  variolous  Infection,  I  consented  that 
Abraham  Howard,  the  first  Child  mentioned  at  my  Examination, 
should  be  vaccinated.  The  Cow  Pox  terminated  successfully,  but 
the  Child  afterwards  sickened,  and  had  an  eruption,  which  I  con- 
sidered the  Small  Pox,  though  others  called  it  an  Hybrid  Eruption, 


LIFE  AND  LETTERS.  iqi 


;ui  appearance  which  I  was  told  had  been  described  as  not  un- 
common at  the  Small  Pox  Hospital,  when  the  patient  had  been 
previously  in  a  variolous  Atmosphere. 

"  Two  other  Cases '  however  were  followed  by  distinct  and 
unequivocal  Small  Pox  after  Vaccination,  and  then  it  was  admitted 
that  the  Cow  Pox  would  not  arrest  the  progress  of  variolous 
Infection  ;  although  it  is  well  known.  Inoculation  of  the  Small 
Pox  within  a  limited  period  will  supersede  and  subdue  it. 

"  These  Cases  ascertained  that  there  was  no  such  thing  as  an 
Hybrid  or  Mulish  Eruption,  but  that  what  had  been  called  so  at 
the  Small  Pox  Hospital  was  the  real  Small  Pox. 

"  I  appeal  therefore  to  persons  of  Discernment,  whether  such 
mistakes,  in  the  outset  of  a  new  practice,  were  not  sufficient 
grounds  for  a  cautious  man  to  admit  some  doubts  of  the  danger 
of  introducing  a  new  disease  into  the  human  system.  The  opinion 
which  I  gave  to  the  Committee,  was  supported  by  such  proofs,  in 
the  answers  sent  to  their  enquiries  and  published  in  their  Report, 
from  Messrs.  Slater  of  Wycomb,  Grosvenor  of  Oxford,  Nooth  of 
Bath,  and  Dr.  Hope  of  Haslar  Hospital,  that  what  I  have  seen 
and  heard  since,  has  only  served  to  determine  me  not  to  be  misled 
by  the  fashionable  rage. 

"  The  steady  and  single  opinion  I  have  maintained  in  opposition 
to  this  practice,  has  brought  me  acquainted  with  some  new  Erup- 
tions, Abscesses  and  Disorders,  which  I  had  not  before  observed  ; 
but  these  accidents  are  generally  attributed  to  a  Spurious  sort  of 
Cow  Pox,  This  is  a  term  I  do  not  admit  of;  I  know  of  no  such 
thing  as  Spurious  Small  Pox,  Spurious  Lues  Venerea,  Spurious 
Scrofula.  We  are  yet  left  unsatisfied  as  to  the  nature  and 
origin  of  what  is  called  Cow  Pox.  It  is  a  disorder  known  only 
to  the  Cow  Doctor  in  dirty  dairies,  though  we  are  taught  to  play 
with  it  as  a  blessing  revealed  from  Heaven  to  this  enlightened  age. 

"  If  I  wished  to  corroborate  the  grounds  for  my  doubts,  I  might 
mention  an  almost  equally  fashionable  rage,  which  had  seized  too 
man}^  of  the  faculty,  previous  to  the  appearance  of  Cow  Pox,  in 
favour  of  the  Nitrous  Acid,  as  a  remedy  for  the  Venereal  Disease. 
Mercury  was  no  longer  to  be  called  in  aid,  and  the  press  teemed 

'  Will.  Rinch,  M.  Solloway — vide  Rejhort. 


192  EDWARD  JENNER. 

with  publications  to  prove  the  mistaken  opinions  of  hospital  Sur- 
geons. This  Novelty  I  resisted  with  equal  firmness  ;  here  I  was 
unwilling  to  give  up  Experience  for  Experiment^  wanting  nothing 
more  safe  or  certain  than  Mercury,  which  for  so  many  years,  in 
the  practice  of  so  many  competent  Judges,  had  proved  an  Antidote 
to  that  malignant  poison.  The  advocates  for  the  Nitrous  Acid 
are  now  no  longer  heard  of,  the  books  on  the  subject  no  longer 
regarded. 

"  Sacrificing,  therefore,  every  consideration  to  my  actual  Opinion, 
I  have  avoided  the  practice  of  Vaccination,  but  I  have  watched  the 
result  of  it.  I  do  not  mean  to  enter  into  the  proof  of  its  failures, 
or  mistakes:  Mr.  Goldson  has  published  some,  in  a  very  candid 
pamphlet — more  are  expected  from  another  pen  ;  and  unless  the 
first  Projectors  have  something  better  to  say,  than  what  has  yet 
been  said,  to  reconcile  the  public  mind  to  those  Cases  of  Mr. 
Hodges'  children,  in  Fullward's  Rents,  Holborn,  I  shall  continue 
firm  in  the  opinion  I  gave  to  the  Committee  of  the  House  of 
Commons,  That  what  has  been  called  the  Cow  Pox  is  not 
A  preservative  against  the  Natural  Small  Pox." 

On  the  other  hand,  Dr.  Lettsom  came  forward  to 
fight  Jenner's  battles.  The  Medical  Society  of 
London  conferred  a  gold  medal  upon  Jenner  in 
honour  of  his  discovery,  and  at  the  anniversary 
festival,  Dr.  Lettsom  delivered  an  oration  on  vaccina- 
tion. V'^arious  honours  and  marks  of  distinction  were 
conferred  upon  Jenner  about  this  time,  both  at  home 
and  abroad.  Clergymen  warmly  advocated  the  practice 
of  vaccination.  The  Rev.  Dr.  Booker,  of  Dudley, 
jjrinted  sermons  on  the  subject,  and  thus  promoted 
the  practice.      In   a  letter  of  his  to  Jenner,   we  read  : — 

"  You  will  see,  however,  in  the  annexed  address  to  parents  on 
the  subject,   that  I  have  done  m.ore  than  recommend  it  from  the 


LIFE  AXD  LETTERS.  193 


pulpit.  One  of  these  printed  forms  I  give  to  every  person  who 
brings  a  child  to  be  baptized  either  at  church  or  at  my  own  resi- 
dence, or  when  sent  for  to  baptize  abroad.  By  this  means  1 
distribute  about  twenty  a  week,  and  have  the  satisfaction  to  learn 
that  the  expedient  has  produced  the  desired  effect.  It  influences 
at  a  time  when  mankind  are  easily  convinced  of  the  precarious 
tenure  of  infantine  existence." 

The  Rev.  James  Plumptre  preached  a  sermon  on 
vaccination  at  Cambridge,  and,  again,  at  the  parish 
church,  Hinxton,  taking  as  his  text,  "  And  he  stood 
between  the  dead  and  the  Hving,  and  the  plague  was 
stayed." 

The  practice  was  still  strongly  opposed  by  an 
influential  section  of  the  medical  profession  ;  but  while 
troubled  with  this  hostility  at  home,  Jenner  derived 
very  soothing  consolation  from  the  accounts  which 
were  received  of  the  progress  of  vaccination  abroad. 

In  1805,  Jenner  was  again  in  London,  discussing 
with  his  friends  "  the  establishment  of  vaccination  and 
the  advancement  of  his  private  fortune."  Lord  Henry 
Petty,  who  had  taken  up  the  cause  of  vaccination,  had 
become  Chancellor  of  the  Exchequer  ;  and  the  Duchess 
of  Devonshire  promised  her  influence.  On  the  other 
hand,  in  1806,  Birch ^  published  his  reasons  for  olojecting 
to  the  practice  of  vaccination.  It  was  by  far  the  most 
temperate  of  the  arguments  against  the  new  practice, 
and   deserves  to  be  quoted    in  extenso. 

'  Serious  Reascns  for  uniformly  ohjectiitg  to  the  Practice  of  Vaccina- 
tioti,  in  A  nswer  to  the  Report  of  the  Jeniierian  Society.     1806. 
VOL.     I.  13 


194  EDWARD  JENNER. 

"That  the  enthusiasm  with  which  Vaccination  was  at  first 
adopted  should  subside,  and  that  the  PubUc  should  express  regret 
that  what  ought  to  have  been  admitted  as  an  experiment  only,  had 
been  adopted  as  practice,  are  circumstances  which,  it  was  easy  to 
foresee,  would  sooner  or  later  occur.  In  all  investigations,  and  in 
all  inquiries.  Truth  must  ultimately  prevail.  In  the  present,  it 
would  have  long  since  prevailed,  had  not  the  patrons  of  Vaccina- 
tion had  recourse  to  such  expedients  to  interest  the  passions,  and 
mislead  the  judgment,  of  the  Public  as  could  hardly  fail  of  obtain- 
ing for  their  system  a  temporary  kind  of  success.  But  the 
triumph  of  prejudice  and  novelty  will  always  be  transient.  The 
empire  of  Truth  alone  is  permanent.  I  entertain  no  doubt,  there- 
fore, but  that  we  shall  soon  see  what  yet  remains  of  popular 
opinion  favourable  to  the  cause  of  Vaccination  vanish  into  thin 
air ;  and  that  the  speculatists  in  physic,  like  the  speculatists  in 
politics,  will  be  brought  back  to  the  old  standard  of  sober  reason 
and  experience. 

"  Impressed  with  this  conviction,  I  should  have  patiently 
awaited  the  event  ;  and,  contenting  myself  with  having  declared 
my  opinion  publicly,  should  have  forborne  taking  any  part  in  the 
controversy,  had  it  not  been  for  considerations  of  humanity,  which 
supersede  every  other. 

"  Wherever  I  go,  I  find  the  minds  of  parents  distracted  with 
doubt,  and  labouring  under  gloomy  apprehensions.  They  tell  me 
that  the  fluctuations  of  medical  opinion  concerning  the  origin  and 
nature  of  the  Vaccine  disease  fill  them  with  alarm  ;  and  they  say 
they  are  in  the  most  fearful  state  of  suspense,  dreading  lest  what 
they  were  persuaded  to  do  in  the  hopes  of  saving  their  children 
from  one  disease,  may  not  prove  the  means  of  plunging  them  into 
another  at  once  novel  and  malignant. 

"  Much  as  I  lament  their  being  in  so  distressing  a  state  of 
suspense,  I  cannot  wonder  at  it.  For  while,  on  the  one  hand,  they 
hear  of  repeated  instances  of  the  failure  of  Vaccination,  on  the 
other,  they  find  that  reports  from  the  Jennerian  Committee,  sub- 
scribed by  names,  some  of  the  highest  respectability,  are  widely 
circulated,  full  of  seeming  arguments  and  assertions  in  favour  of 
the  experiment ;  assertions  which  they  have  not  the  means  of 
contradicting,    and    arguments    just     plausible    enough    to   excite 


LIFE  AND  LETTERS.  195 

doubt,  but  not  sufficiently  strong  to  operate  conviction.  If,  under 
these  circumstances,  I  can  adduce  what  may  enable  persons  of  this 
dcscrijition  to  form  a  fixed  opinion  on  the  merits  of  Vaccination, 
and  thus  rescue  them  from  the  misery  of  uncertainty,  I  shall 
consider  myself  as  having  discharged  one  of  the  most  important 
duties  I  owe  Society. 

"  Such  is  the  primary  motive  for  my  writing  the  following 
pages  :  a  secondary  motive  is,  that  as  the  Jennerian  Committee 
have  sent  me  their  Report  of  last  January  for  my  signature,  I 
may  candidly  tell  them  why  I  have  hitherto  forborne  to  subscribe 
it,  and  why  I  shall  never  subscribe  it.  To  this  report  therefore, 
and  to  a  very  ingenious  pamphlet  written  by  Mr.  James  Moore, 
certainly  the  ablest  and  most  candid  writer  that  has  appeared  in 
support  of  Vaccination,  I  shall  confine  as  much  as  possible  my 
remarks.  The  bitterness  of  invective,  and  the  unhandsome 
sneers,  with  which  the  partisans  of  Vaccination  have  assailed 
their  opponents,  as  they  offer  no  argument,  merit  no  reply. 

"The  Report  opens  by  stating  that  the  Medical  Council  ap- 
pointed twenty-five  members  of  the  Jennerian  Society  as  a 
Committee  to  inquire  into  the  truth  of  various  cases  that  had 
occurred,  excitmg  prejudices  against  Vaccine  Inoculation  ;  and  it 
is  the  result  of  their  inquiries  that  is  submitted  to  the  Public. 

"Now,  without  calling  in  question  the  judgment  of  the  Medical 
Council,  I  must  observe  that  it  became  them,  in  a  matter  of  such 
importance,  to  inform  us  who  these  twenty-five  persons  were. 
For  as  the  Societ}^  is  very  numerous,  comprehending  many  cf 
both  sexes,  and  of  all  professions,  the  Committee  might  have 
been  formed  of  persons  not  altogether  competent  to  the  task  : 
since  evidently,  besides  what  may  be  called  a  knowledge  of 
\'accination,  it  was  necessary  there  should  be  likewise  a  thorough 
knowledge  of  medicine.  In  other  words,  the  Public  ought  to  have 
been  assured  that  the  Committee  was  composed  of  regular  and 
experienced  physicians  and  surgeons  before  they  could  be  in 
reason  expected  to  assent  to  its  decisions  :  instead  of  which  we 
have  a  Committee  made  up  of  persons  whose  very  names  we  are 
unacquainted  with.  I  confess  that  this  circumstance,  in  my  mind, 
throws  as  much  suspicion  over  the  Jennerian  Reports,  as  it  would 
over  a  verdict  in  a  common  court  of  law  to  be  told,  that  it  was  the 


EDWARD  JENNER. 


verdict  of  a  jury,  no  one  member  of  which  the  defendant  was 
permitted  to  challenge  ;  whose  names,  conditions  and  character 
were  studiously  concealed ;  and  who  had  never  so  much  as 
appeared  in  court  during  the  trial. 

"  This,  however,  is  not  the  only  circumstance  that  makes  me 
regard  with  an  eye  of  suspicion  the  Reports  of  the  Committee. 
The  several  articles  of  that  Report  are  couched  either  in  a  style  so 
dogmatizing,  that  the  Committee  seem  more  intent  on  imposing  a 
law  than  on  producing  conviction  ;  or  else  in  terms  so  vague,  and 
ambiguous,  that  the  reader  must  be  at  a  loss  to  obtain  any  fixed 
and  definitive  idea  of  the  subject.  The  former  of  these  faults  I 
will  pass  over,  as  it  may  be  attributed  to  the  force  of  the  con- 
viction entertained  by  the  Committee  of  the  justness  of  their 
positions  :  but  the  latter,  as  an  honest  man,  I  cannot,  since  it  has 
a  tendency  to  mislead,  rather  than  direct  the  judgment  of  the 
Public.  Surely  the  Committee  are  aware  that  nothing  is  moie 
suspicious  than  the  use  of  equivocal  expressions  ;  and  that  there 
is  nothing  the  candid  disputant  more  scrupulously  avoids.  By 
means  of  these  confessions  of  error,  extorted  by  truth,  may  be 
made  no  confessions  at  all  ;  may  be  so  worded  as  to  produce  no 
effect,  and  yet  carry  with  them  the  appearance  of  candour,  and 
concession.  I  will  instance  the  truth  of  this  remark  in  the  Ninth 
and  Tenth  Article  of  the  Jennerian  Report. 

"The  Committee,  being  at  last  compelled  to  acknowledge  that 
cases  have  been  brought  before  them,  in  which  it  was  incon- 
testibly  proved  that  persons  having  passed  through  the  Cow  Pox 
in  a  regular  way,  had  afterwards  received  the  Small  Pox,  contrive 
to  destroy  the  effect  of  the  concession,  by  the  following  ambiguous 
expressions. 

"It  is  admitted  that  a  few  cases  have  been  brought  before 
them,  of  persons  who  had  apparently  passed  through  the  Cow 
Pox  in  a   regular  way,  etc. 

"  Now  (not  to  remark  on  the  use  of  the  indefinite  word  feiv, 
which  may  mean  five  or  six,  or  five  or  six  dozen,  for  ought  we 
know,  when  it  was  so  obviously  important,  and  easy  to  have 
specified  the  precise  number),  I  must  observe,  that  as  the  pas- 
sage stands  worded,  it  might  seem  as  if  the  Committee,  having 
seen  all  the  cases  of  failure  in  Vaccination  that  could  be  produced, 


LTFE  AND  LETTERS. 


197 


found  only  a  feiv  they  could  admit  to  be  genuine.  How  many 
cases  they  did  see,  1  will  not  take  upon  me  to  conjecture  ;  I 
suspect  they  did  not  wish  to  see  many,  for  if  they  had,  they 
might  have  seen,  or  have  had  unquestionable  testimony  of  many 
hundred  cases  of  failure,  of  which  not  a  feiv,  but  far  the  greater 
part,  if  not  the  whole,  would  have  been  found  conclusive  against 
them. 

"But  it  is  said,  'apparently  passed  through  the  Cow  Pox.' 
What,  only  apparently  ?  If  the  Committee  had  not  been  satis- 
fied the  patients  had  really  passed  through  the  Cow  Pox,  the}'^ 
neither  would,  or  ought  to,  have  admitted  the  failure  of  what 
they  call  a  feiv  cases.  Why  then  is  the  word  '  apparently ' 
introduced  ?  I  can  imagine  no  other  cause,  than  that  this  equi- 
vocal word  might  serve  to  qualify  the  confession  of  the  Com- 
mittee, and  thus  make  it  appear  less  conclusive  than  it  really  is. 

"  But  this  is  not  all.  The  Committee  proceed  to  say,  that 
'cases  supported  by  evidence  equally  strong  were  brought  before 
them  of  persons  having  had  the  Small  Pox  a  second  time  by 
natural  infection. ' 

"Will  the  Committee  pardon  me  if  I  remark  that  they  are 
here  guilty  of  reasoning  very  unfairly,  to  say  no  worse  of  it.  In 
the  one  instance  they  argue  from  cases  brought  before  them :  in 
the  other,  from  the  evidence  of  cases  brought  before  them.  That 
is,  when  a  case  makes  against  them,  they  admit  no  proof  but 
the  evidence  of  their  own  senses  :  when  it  is  favourable  to  their 
cause,  they  admit  it  on  the  evidence  of  others.  In  fair  reason- 
ing, in  both  instances,  a  similar  degree  of  proof  ought  to  be 
required.  If  cases  on  the  testimony  of  others  are  admitted  to 
prove  the  failure  of  inoculation,  cases  on  the  testimony  of  others 
should  be  admitted  to  prove  the  failure  of  Vaccination  ;  and  then 
the  Committee  will  be  compelled  to  state  that  not  merely  a  few 
cases,  but  that  many  hundred  cases  of  failure  have  occurred  :  for 
many  hundred  cases  are  already  before  the  public  of  persons 
who  have  had  the  Small  Pox  after  Vaccination,  attested  by  the 
evidence,  not  of  hasty  observers  and  unscientific  operators,  but  of 
able  and  experienced   practitioners. 

But  this  is  not  the  only  instance  of  unfair  reasoning  I  am  to 
complain  of  on   the  part  of  the  Jennerian  Committee. 


EDWARD  JENNER. 


"  They  say,  '  In  many  of  the  cases  in  which  Small  Pox  has 
occurred  after  Inoculation  ! '  Many  of  the  cases  I  This  expres- 
sion I  presume  is  to  contrast  with  the  few  cases  of  failure 
admitted  in  Vaccination,  and  the  reader  is  left  to  infer  that  cases 
of  failure  in  Inoculation  are  of  frequent  recurrence  ;  than  which 
inference  nothing  can  be  more  unfounded,  more  contrary  to  truth. 

For,  in  the  first  place,  if  we  could  grant  all  the  cases  that  have 
been  adduced  on  anything  like  proof,  to  attest  the  recurrence  of 
Small  Pox  after  Inoculation,  these,  during  a  period  of  more  than 
half  a  century,  would  not  amount  to  more  than  three. 

"  But,  in  the  second  place,  the  fact  itself  has  been  uniformly 
denied  by  the  best  and  most  able  practitioners.  They  have 
always  maintained  that  the  Small  Pox  never  has  been  known  to 
recur  after  Inoculation  ;  and  however  the  contrary  may  be  as- 
sumed by  those  who  have  systems  of  their  own  to  advance,  it  is 
considered  as  one  of  the  invariable  laws  of  nature,  that  (and 
if  an  exception  could  be  proved,  1  should  be  justified  in  saying, 
exceptio  probat  regulani)  a  patient  can  suffer  the  Small  Pox  but 
once. 

"  I  might  quote  in  support  of  my  opinion,  that  of  the  cele- 
brated Baron  Dimsdale,  Dr.  Archer,  and  many  others  ;  but  it 
will  be  of  greater  authority,  in  the  present  case,  to  quote  the 
opinion  of  Mr.  J.  Moore,  the  candid  supporter  of  Vaccination, 
who  admits  in  his  pamphlet,  that  Small  Pox  does  not  recur  after 
Inoculation. 

"  I  have  dwelt  longer  on  these  two  Articles,  than  I  probably 
shall  on  any  of  the  succeeding,  that  I  might  put  the  Reader  on 
his  guard  against  the  false  conclusions  into  which  he  might 
otherwise  be  led,  by  the  ambiguous  manner  in  which  the  Com- 
mittee write.  And  I  shall  dismiss  this  part  of  the  subject  by 
saying,  that  the  same  inaccuracy  of  expression  (whether  acci- 
dental or  studied,  I  presume  not  to  decide)  that  reigns  in  this 
particular  instance,  reigns  throughout  the  whole  of  the  Report. 
So  that  the  inference,  drawn  of  old  from  the  artful  conduct  of 
a  single  individual  to  the  craftiness  of  a  whole  race,  may  be 
applied  to  the  arguments  of  the  Committee, 

"  '  Crimine   ab  uno, 
Disce  omncs ' 


LIFE  AND  LETTERS.  199 


"  Let  us  now  follow  the  Committee  to  other  particulars : — 

"They  proceed  to  assert,  that  most  of  the  cases  they  examined 
were  misstated,  or  unfounded. 

"  If  they  allude  to  the  cases  mentioned  by  Mr.  Rogers  in  his 
Pamphlet  entitled,  '  Examination  of  the  Evidence  before  the  House 
of  Commons,'  I  pledge  my  word  as  a  man,  and  my  character  as 
a  professional  person,  to  prove  them  all.  Nay,  further,  I  pledge 
myself  if  more  cases  are  necessary,  to  produce  many,  alas  !  too 
many  more,  of  Variolous  Infection  caught  after  regular  Vaccina- 
tion. But  of  the  abundant  number  of  cases  laid  before  the 
Public,  the  majority  cannot  be  either  misstated,  or  unfounded  ; 
and  if  so,  the  cause  of  the  Committee  falls  at  once  to  the  ground. 
For  granting  (what  never  can  be  granted)  that  only  one-third  of 
the  cases  adduced  were  substantiated,  there  would  remain  above 
one  hundred  and  fifty  instances  of  acknowledged  failure  :  and 
surely  these  would  be  sufficient  to  convince  any  dispassionate 
person,  that  Vaccination  is  not,  and  cannot  be,  a  preservative 
against  the  Small  Pox.  What  shall  we  say  then,  when,  in  addi- 
tion to  this,  it  is  proved,  that  several  patients  have  died  of  the 
immediate  consequences  resulting  from  the  puncture  of  Vaccina- 
tion ;  while  on  the  other  hand  it  never  was,  or  could  be  with 
an}'  truth,  asserted  that  similar  fatal  consequences  had  in  a 
single  instance  resulted  from  the  puncture  of  Small  Pox  Inocu- 
lation ?  The  inoculated  patient,  if  he  dies  (which  is  not  one 
in  three  hundred  in  the  general  irregular  mode  of  proceeding, 
and  not  one  in  a  thousand  among  observant  practitioners),  dies 
of  Small  Pox,  and  of  nothing  but  Small  Pox ;  the  appearance  of 
the  punctured  arm  is  uniformly  the  same ;  and  the  treatment 
of  it  is  one  of  those  judicious  points  in  surgery,  peculiar  to  Baron 
Dimsdale's  method  of  cure. 

"The  Committee,  to  exonerate  the  Society  from  the  censures 
of  repeated  failures,  state  ;  that  many  persons  not  acquainted  with 
the  Disease,  have  undertaken  to  vaccinate,  and  that  much  of  the 
consequent  ill  success  has  resulted  from  this  circumstance.  But 
they  forget  that  the  principal  evidence  they  themselves  adduced 
to  support  their  cause  before  the  House  of  Commons  was  that 
of  a  Clergyman  ;  they  forget  too,  that  several  of  the  Fanatical 
Preachers  among  the  Sectaries,   have  been  ever  since  the   most 


EDWARD  JENNER. 


zealous  and  approved  champions  of  their  system,  both  in  their 
preachings,  and  practice  ;  together  with  some  Ladies,  who  have 
received  their  instructions  from  Dr.  Jenner  himself.  So  that 
the  same  set  of  people  who  are  disowned,  when  it  is  convenient 
to  disown  them,  are  brought  forward  as  good  evidence,  when  it 
suits  the  cause.  Is  not  this  another  instance  of  that  mala  fides, 
which  throws  a  just  suspicion  over  the  cause  altogether  ? 

"  But  laying  aside  these  equivocal  practitioners,  among  the 
ignorant,  the  Committee,  I  presume,  do  not  mean  to  class  Mr. 
Wachsell,  Apothecary  to  the  Small  Pox  Hospital ;  or  Mr.  Ring, 
the  Accoucheur  ;  and  yet  from  the  patients  vaccinated  by  these 
two  persons,  I  would  bring  instances,  if  the  House  of  Commons 
were  again  to  demand  it  of  me,  of  more  failures,  more  deaths 
and  more  diseases  than  have  occurred  in  the  practice  of  any 
other  two  persons  who  have  come  within  my  knowledge. 

"  It  is  further  asserted  by  the  Committee,  that  when  the  Sniall 
Pox  occurs  after  Vaccination,  it  is  more  mild  than  usual,  and  loses 
some  of  its  characteristic  marks  ;  but  in  many  cases  in  which  it 
recurs  after  Inoculation,  or  the  natural  disease,  it  is  particular]}' 
severe,   sometimes  fatal. 

"  This  article  appears  to  me  extremely  objectionable  and  disin- 
genuous. For,  not  to  mention  the  improper  use  of  the  words, 
many  cases  of  the  recurrence  of  the  Small  Pox  ;  the  Committee 
here  argue  from  an  assumption  of  their  own,  which  as  fair  and 
honest  reasoners,  as  men  having  no  other  object  than  the  investi- 
gation of  truth,  they  never  ought  to  have  done.  Their  assertion 
is,  that  though  Small  Pox  does  sometimes  recur  after  Vaccination, 
this  circumstance  is  not  to  create  any  alarm  ;  for  when  it  doss 
return,  it  is  so  mild  that  even  its  existence  is  doubtful ;  whereas 
in  many  cases  in  which  it  recurs  after  Inoculation,  it  is  particularly 
severe  and  often  fatal.  Thus  arbitrarily  to  assume  the  fact,  that 
Small  Pox  does  occur  after  Inoculation,  a  fact  denied  by  the 
Advocates  of  Vaccination  themselves,  and  then  to  build  on  it  an 
argument  in  favour  of  their  system,  is  in  my  mind  a  mode  of 
proceeding  bordering  on  criminality.  For  if  the  Committee  were 
addressing  their  Reports  to  Medical  Men  only,  no  great  mischief 
would  ensue,  since  the  fallacy  would  be  immediately  detected, 
and  any  argument  built  upon  it  would  of  course  fall  to  the  ground. 


LIFE  AND  LETTERS.  201 

But  as  the  Committee  are  addressing  their  Report  to  Parents,  who, 
being  ignorant  of  the  history  of  Diseases,  are  compelled  to  rely 
iinplicity  on  those  who  profess  to  tell  them  the  truth,  they  ought 
to  have  remembered  it  was  a  solemn  duty  in  their  statement  of 
the  case,  to  have  '  turned  neither  to  the  right  hand,  nor  to  the 
left.'  They  ought  to  have  told  their  readers,  that  the  recurrence 
of  Small  Pox  after  Inoculation  was  a  fact,  supported  b}'  such 
slender  evidence,  so  contrary  to  the  laws  of  nature,  and  so 
generally  discredited,  that  when  it  does  occur,  as  is  supposed, 
a  second  time,  this  is  considered  as  a  proof  that  the  disorder 
which  the  patient  had  in  the  first  instance,  was  not  the  Small 
Pox.  That  the  Committee  therefore  omitting  all  this  should 
boldly  beg  the  question,  and  argue  from  that  as  proved,  which 
is  one  of  the  points  in  dispute,  is  such  an  instance  of  unfair 
reasoning  as  perhaps  it  would  be  difficult  to  parallel. 

"The  assertion  of  the  Committee  in  the  XX'*^  article,  that  the 
'  Diseases  which  are  said  to  origmate  from  Cow  Pox  are  scrophu- 
lous,  and  cutaneous,  and  similar  to  those  which  arise  from 
Inoculation,  is  according  to  my  observation  quite  incorrect. 
Many  of  the  eruptions  are  perfectly  novel.  As  far  as  my  ex- 
perience and  m}'  information  go,  I  will  venture  to  affirm  they 
are  eruptions  of  a  nature  unknown  before  the  introduction  of 
\'accination  ;  and  peculiar  to  those  who  have  been  Vaccinated. 
Such  was  the  case  of  the  child  in  Jermyn  Street :  such  was  that 
of  a  child  near  Guildford,  vaccinated  by  Dr.  Elliot;  and  of  many 
more  whose  names,  from  respect  to  the  parents,  I  forbear  to 
mention. 

"  As  for  Latchfield's  child,  that  case  differed  as  much  in  every 
essential  characteristic  from  Scrophula  as  possible.  The  first 
appearance,  the  increase,  the  colour  of  the  suppurating  part,  and 
the  indelible  dark  Eschar,  all  marked  a  new,  and  undescribed 
disease.     Scrophula  is  a  useful  name  on  various  occasions.     But 

'  "The  words  of  the  Committee  are — "  Complaints  represented  as  the 
effects  of  Vaccine  Inoculation,  when  in  fact  they  originated  from  other 
causes.'"  This  is  another  instance  of  the  bold  manner  in  which  the 
Committee  assert,  to  get  rid  of  difficulties.  What  proof  is  advanced 
that  the  complaints  did  originate  in  other  causes  ?  None  but  the  ipse 
dixit  of  the  writer. 


202  EDWARD  JENNER. 


its  symptoms  are  well  known  and  defined ;  they  cannot  long  be 
confounded  with  those  of  any  other  disease  :  and  when  a  little 
experience  shall  have  made  the  distinction  clear,  then,  if  I  mistake 
not,  many  a  babe  whose  parents  transmitted  to  it  the  fibres  of 
health,  and  vigour,  shall  lament  the  dire  effects  of  unsatisfactory 
experiment ;  while  those  who  may  escape  the  ravages  of  any  new 
disorder,  will  still  tremble  lest  that  dreaded  evil,  the  natural 
Small  Pox,  which  they  sought  to  avoid,  should  in  a  luckless  hour 
overtake  them. 

"  It  is  not  my  intention  to  pursue  further  the  Report  of  the 
Jennerian  Committee.  I  have  answered  whatever  applies  mate- 
rially to  my  argument :  to  expose  all  the  errors  and  fallacies  it 
contains,  would  be  a  painful  task  :  1  should  however  be  unjust 
to  the  Public  and  myself,  did  I  not  state,  that  besides  those  I 
have  already  noticed,  there  are  in  it  assertions  so  unfounded, 
and  expressions  so  ambiguous,  that  these  alone  would  have 
deterred  me  from  subscribing  it. 

"  Thus  in  Article  XVI.  it  is  said,  that  by  means  of  Vaccina- 
tion, the  Small  Pox  has  in  some  populous  Cities  been  wholly 
exterminated. 

"  In  Article  XVIII.  that  the  prejudice  raised  against  Vaccination 
has  been,  in  great  measure,  the  cause  of  the  death  of  near  2,ooo 
persons  this  present  year,  in  London  alone. 

"  In  Article  III.  that  the  cases  published  to  prove  the  failure 
of  Vaccination,  have  been  for  the  most  part  fully  refuted  ;  and 

"  In  Article  IV,  those  Medical  Men  who  dissent  from  the 
Jennerian  Committee,  are  stated  generally,  as  acting  perversely 
and  disingenuousl}' ;  persisting  in  bringing  forward  unfounded, 
and  refuted  reports ;  and  even  misrepresentations,  after  they  have 
been  proved  to  be  such. 

"  Of  these  Articles  I  am  compelled  to  say,  and  am  ready  to 
prove,  that  the  three  first  are  absolutely  unfounded.  Of  the  last 
I  must  declare,  that  it  seems  to  me  conceived  in  a  spirit  of 
illiberality  and  ungenerous  censure,  such  as  I  should  ha\e 
imagined  a  Committee  formed  of  Gentlemen  never  would  have 
used  ;  and  which  certainly  no  circumstances  can  justify. 

"  I  presume  not  to  judge  the  motives  of  action  in  others  ;  I 
know  my  own,  and   I  am  conscious  of  my  sincerity.     If  I   could 


LIFE  AND  LETTERS. 


203 


be  actuated  by  party  spirit,  I  should  be  unworthy  the  confidence 
of  the  PubHc.  I  seek  for  Truth,  and  Truth  alone.  With  indig- 
nation, therefore,  do  I  reject  the  charge  of  acting  perversely,  and 
disingenuously.  When  1  am  convinced  of  error,  I  shall  take  a 
pride  in  acknowledging  my  mistake  ;  'till  then  I  shall  consider 
it  my  duty  to  declare  my  opinion  openly,  and  to  state  the  reasons 
why  I  have  from  the  first  asserted,  and  why  I  still  continue  to 
assert,  that  I  fear  the  experiment  of  Vaccination  will  be  found 
injurious  to  the  peace,  the  health,  and  the  welfare  of  society.^ 

"But  since  motives  of  action  are  called  in  question,  let  me 
mention  a  few  of  the  circumstances  that  have  contributed  to 
influence  my  conduct  :  they  will  be  found  to  bear  more  upon  the 
argument  than  may  at  first  be  imagined.  I  will  afterwards 
proceed  to  offer  a  few  strictures  on  Mr.  J.  Moore's  pamphlet. 

"  The  paper  which  1  published  in  the  Gentleman' s  Magazine, 
and  which  1  shall  here  reprint,  shews  the  ground  I  had  to  stand 
upon,  in  opposing  the  experiment  at  its  very  commencement.  I 
have  never  changed  my  opinion  ;  I  have  uniformly  maintained 
that  it  was  a  dangerous  practice  to  introduce  a  new  source  of 
disease  into  the  human  frame. 

"If  I  have  been  firm  in  my  sentiments,  it  is  because  I  have 
met  with  nothing  in  the  sequel  that  has  shaken  my  judgement. 

'  "  Though  1  admit  with  the  Committee,  the  impropriety  of  discussing 
subjects  of  serious  investigation  in  any  other  than  a  serious  style,  I 
must  object  to  the  manner  in  which  they  have  worded  their  Vth  Article. 
Having  said,  some  "printed  accounts,  adverse  to  Vaccination,  have 
treated  the  subject  with  indecent  and  disgusting  levity"  (expressions 
I  think  much  too  strong,  and  coarse)  they  add,  "as  if  the  good  or  evil 
of  society,  were  fit  objects  for  sarcasm,  and  ridicule.'  This  seems  to  me 
an  invidious,  and  an  unfair  manner  of  stating  the  question.  The  £:'oad  and 
evil  of  society  never  were  the  objects  of  ridicule.  But  a  system  being 
advanced,  which  it  was  apprehended  would  ultimately  prove  an  evil,  not 
a  good,  it  was  thought  proper  to  attack  that  system  :  and  while  *  some 
chose  the  sober  method  of  argument,!  others  preferred  that  of  ridicule  : 
still,  however,  it  was  W\&  system,  not  the  good  or  evil,  that  was  ridiculed: 
and  that  system  was  ridiculed  only  so  far  as  it  was  judged  likely  to  injure, 
rather  than  benefit,  society. 


*  Mr.  Rogers,  and  Mr.  Lipscombe. 
t  Dr.  Moseley,  Imcs  Bovilla. 


204  EDWARD  JENNER. 


"  It  is  true  the  opinion  of  some  of  my  colleagues  was  in  direct 
opposition  to  mine.  I,  therefore,  felt  it  incumbent  on  me,  carefully 
and  dispassionately  to  observe  the  result  of  the  experiment.  I 
did  so  :  I  read  what  was  published  ;  and  I  found  from  time  to 
time  such  contradiction  in  the  Reports  of  the  advocates  for  Vac- 
cination ;  such  fluctuation  in  their  opinion  ;  such  inconsistency  in 
their  practice  ;  that  the  most  favourable  conclusion  I  could  tlraw 
was,  they  knew  not  what  they  were  doing.  Surely  this  did  not 
authorize  me  to  alter  my  original  position. 

'*  To  obviate  the  objections  naturally  raised  from  this  extreme 
uncertainty-,  and  which  evidentl}^  affected  the  soundness  of  the 
principle  on  which  the  system  rested,  Vaccination  was  divided 
into  Spurious  and  Genuine.  I  foresaw  the  consequences.  I  was 
satisfied  that  the  Jennerian  Society,  having  once  embarked  in  the 
cause,  would  have  recourse  to  any  expedient,  rather  than  abandon 
it  :  and  finding  I  stood  nearly  single,  and  that  the  tide  of  Opinion 
set  strong  against  me,  I  patiently  submitted  to  have  my  judge- 
ment called  in  question  for  a  season,  resolving  to  wait  a  proper 
period  to  explain  my  reasons  of  dissent. 

"  The  Cases  of  Mr.  Hodge's  Children  occurred,  confirming  the 
truth  of  Mr.  Goldson's  Reports.  I" then  thought  it  my  dut}'  to 
print  my  opinions  in  support  of  what  that  Gentleman  had 
advanced.  What  I  then  wrote,  and  all  I  have  written  since,  has 
been  couched  in  the  language  of  Seriousness,  and  Candour,  not 
of  levity  or  prejudice.  Never  shall  I  be  ashamed  that  I  was  the 
first  to  express  a  doubt  whether  Inoculation,  so  perfectly  under- 
stood, and  so  successfully  managed  as  it  was,  ought  to  be 
abandoned  lor  a  mere  Experiment  ;  holding  the  change  too 
serious  a  matter,  to  be  trifled  with :  neither  shall  I  ever  be 
ashamed  to  say,  that  I  viewed  with  indignant  scorn  the  un- 
generous artifice  adopted  by  the  Jennerian  Society,  of  sticking  up 
in  every  Station-house,  in  the  Vestries  of  fanatical  Chapels,  and 
in  Sunday  Schools,  that  false,  Comparative  View  of  the  Effects  on 
Individuals,  and  Society,  by  the  Sniall  Pox,  and  the  Cow  Pox, 
ornamented  with  tablets  like  a  School-boy's  writing-piece,  re- 
presenting to  the  gaping  multitude  a  frightful  picture  of  Inocula- 
tion, with  the  supposed  misery  attendant  on  it  ;  and  exhibiting 
representations   equally   false,   and   exaggerated,    of  the   blessings 


LIFE  AND  LETTERS. 


205 


of  Vaccination.  When  I  saw  ti.is,  and  afterwards  understood 
that  these  disgraceful  Pictures  were  intended  for  the  use  of  our 
distant  Colonies,  where  the  Truth  would  long  be  concealed, 
and  Argument  be  totally  lost,  I  was  compelled  to  suspect,  still 
more  and  more,  not  only  the  goodness  of  the  cause  itself,  but  the 
Candour  of  those  who  stooped  to  such  means  in  its  support. 

"Soon  after  this,  I  heard  with  great  surprise  that  an  application 
had  been  made  to  the  late  Archbishop  of  Canterbury,  persuading 
his  Grace  to  direct  the  Clergy  of  the  Church  of  England  to 
recommend   Vaccination  frcm  their  pulpits. 

"  I  received  a  letter  from  the  Palace  at  Lambeth,  desiring  to 
know  if  I  had  changed  the  opinion  I  had  originally  advanced  ; 
and  a  respectable  Clergyman  waited  on  me  from  his  Grace,  to 
talk  with  me  on  the  subject.  Without  entering  into  any  argument, 
I  contented  myself  with  relating  to  him  all  I  knew  :  shewed  him 
my  correspondence  with  other  medical  men  on  the  subject,  and 
left  him  to  judge  for  himself.  He  retired  from  me,  saying,  '  His 
Grace  must  not  commit  the  Church! — This  transaction  is  perfectly 
well  known,  I  believe,  to  all  tlie  Partisans  of  Vaccination.  Why 
it  has  never  been  hinted  at  by  any  of  the  writers  in  favour  of  the 
Cause,  and  why  it  has  been  concealed,  is  a  secret  best  known  to 
themselves,  and  the  Jennerian  Committee. 

"These  circumstances  occasioned  an  increased  degree  of  distrust 
in  my  mind  ;  and  called  more  loudly  for  care  and  circumspection  ; 
especially  when  I  recollected  the  Anniversary  dinner  of  Mr.  Guy's 
hospital  in  1 802,  where  I  expected  to  meet  the  Professors,  the 
Medical  Gentlemen,  and  the  Students,  on  the  same  terms  as 
usual.  What  was  my  surprise  then  to  find,  that  the  sole  business 
of  the  meeting  was  to  begin  a  canvass  for  names  to  a  petition  to 
Parliament,  in  support  of  Dr.  Jenner's  bill  ?  it  was  presented  to 
me,  and  I  refused  to  sign  it. 

"  My  surprise  was  increased  after  the  dinner,  to  find  that  toasts, 
songs,  and  compliments  from  one  Professor  to  another  in  honour 
of  Vaccina,  were  the  order  of  the  day. 

"As  I  had  seen,  among  the  various  business  of  life,  some  politi- 
cal manoeuvres,  and  the  management  of  some  party  schemes,  I 
was  not  at  a  loss  to  conjecture  in  what  manner  the  cause  of 
Vaccination  would  be  carried  on. 


2o6  EDWARD  JENNER. 

"  The  Royal  Patronage,  the  authority  of  Parliament,  would  ])e 
made  use  of,  beyond  what  the  sanction  given  warranted  :  the 
command  of  the  Army  and  Navy  would  be  adduced,  not  merely 
as  the  mean  of  facilitating  the  experiment,  but  as  proof  of  the 
triumph  of  the  cause  :  and  above  all,  the  monopoly  of  the  press, 
and  the  freedom  of  the  Post  Office  would  be  employed  to  circulate 
the  assertions  of  the  friends  of  Vaccination,  and  to  suppress  the 
arguments  of  their  opponents. 

"What  I  foresaw  happened:  and  such  was  the  influence  of  the 
Jennerian  Society,  that  many  publishers  and  booksellers  refused 
to  print,  or  sell  such  works  as  might  be  deemed  adverse  to  Vac- 
cine Inoculation  :  in  consequence  of  which  it  was  hardly  possible, 
at  the  first  moment,  to  contradict  any  thing  the  Society  chose  to 
assert.  It  was  in  vain  to  argue  against  the  system  ;  for  even 
the  Ladies  themselves  were  prejudiced,  were  influenced,  and 
employed  in  its  defence.  Men  midwives  found  their  interests 
were  essentially  connected  in  its  success  ;  and  they  foresaw  that 
if  they  could  vaccinate  at  the  breast,  without  danger  of  conveying 
infection,  they  should  secure  to  themselves  the  nursery,  as  long 
as  Vaccination  lasted  :  no  one  could  enter  to  interfere  with  them  ; 
they  would  prescribe  for  the  Apothecary,  and  hold  him  at  a 
distance  ;  the  Physician  and  Surgeon  would  be  set  aside ;  and  if 
any  accident  occurred  that  rendered  a  dissection  after  death 
necessary,  some  anatomist,  friendly  to  the  cause,  might  be  called 
in  to  quiet  the  alarms  of  a  family. 

"  The  College  of  Physicians  seem  at  last  to  have  opened  their 
eyes  to  the  innovations  of  these  practitioners,  who,  like  the 
Jesuits  of  old,  through  the  medium  of  the  female  branches,  aim 
at  managing  the  whole  family. 

"  They  have  therefore  forbidden  them  to  prescribe  in  future  for 
children  above  two  years  old  ;  that  safe  age,  before  which,  unless 
in  peculiar  cases,  according  to  Baron  Dimsdale,  Inoculation  ought 
not  to  be  performed  ;  and  that  for  self-evident  reasons.  For  if 
the  loss  of  beauty,  or  the  probability  of  danger  are  proportionate 
to  the  crop  of  pustules  on  the  face,  who,  but  one  ignorant  of 
Surgery,  would  advise  that  bed  of  roses,  the  blooming  cheeks  of 
an  infant,  during  the  eruptive  fever  of  Small  Pox,  to  be  applied  to 
the  warm  breast  of  a  well-fed  nurse  ?     What  maturating  poultice 


LIFE  AND  LETTERS. 


is  more  likely  to  invite  the  pustules  to  that  part  ?  Against  this 
practice,  every  notion  of  sound  sense  revolts  ;  and  I  will  venture  to 
affirm  that  the  majorit}-  of  children  who  suffer  from  Inoculation, 
are  those  inoculated  at  the  breast. 

"When,  therefore,  such  pains  are  taken  to  magnify  the  numbers 
that  fall  victims  to  Small  Pox,  why  is  not  this  pernicious  custom, 
which  ever}' sound  practitioner  reprobates,  taken  into  the  account? 
and  wh}'  is  it  not  remembered  that  in  the  populous  parts  of  the 
Metropolis,  where  the  abundance  of  children  exceed  the  means 
of  providing  food  and  raiment  for  them,  this  pestilential  disease 
is  considered  as  a  merciful  provision  on  the  part  of  Providence,  to 
lessen  the  burthen  of  a  poor  man's  famih'  ? 

"  Let  the  College  of  Ph3^sicians,  who  examine  the  Apothecaries* 
shops  in  the  narrow  streets,  and  suburbs  of  London,  report  the 
state  of  the  medicines,  the  scales  and  measures,  and  the  annual 
reproofs  the}'  are  constrained  to  make  to  many,  where, 

"  ' among-  the  shelves 


A  beggarly  account  of  empty  boxes, 
Green  earthen  pots,  bladders,  and  musty  seeds, 
Remnants  of  packthread,  and  old  cakes  of  roses 
Are  thinly  scattered  to  make  up  a  show,' 

and  then,  we  shall  in  some  measure  be  able  to  determine,  how 
little  can  with  justice  be  urged  against  any  particular  mode  of 
practice,  from  the  frequency  of  deaths  among  the  poorer  classes 
of  mankind.^ 

"  Enough  has  been  said  to  explain  wh}',  from  the  first,  I  was  led 
to  regard  with  a  certain  degree  of  suspicion,  the  conduct  of  the 
friends  of  Vaccination ;  and  why  I  have  uniformly  disapproved 
their  proceedings.      It  remains  to  make  some  observations  on  an 


'  "One  of  the  most  prevalent  causes  of  death  among  infants  is  the  loss 
of  their  mothers'  milk.  Women  who  abandon  their  own  children,  to  sell 
their  milk  to  a  stranger,  will  be  found  too  frequently  to  have  destroyed 
their  deserted  babes.  An  Hospital  under  the  Queen's  patronage,  was 
settled  at  Bay's-Water,  to  receive  the  children  thus  deserted,  but  it 
subsisted  a  very  short  period,  for  all  the  children  died.  The  Foundling 
Hospital,  the  Enfant  trouve  at  Paris,  and  the  registers  of  large  parishes, 
will  elucidate  this  fact ;  but  it  is  never  mentioned  in  the  Bills  of  Mortality. 


EDWARD  yENN£R. 


ingenious  pamphlet  written  by  Mr.  J.  Moore,  hitherto  the  best 
defender  of  the  Jennerian  cause.  What  Dr.  Thornton  will  pro- 
duce, who  has  announced  himself  employed  by  the  Committee, 
to  answer  the  wit  of  Dr.  Moseley,  and  the  sober  arguments  of 
Mr.  Lipscombe,  the  event  will  prove.  I  doubt  not  but  that 
Dr.  Moseley  will  be  able  to  answer  all  that  Dr.  Thornton  shall 
advance. 

"  With  respect  to  Mr.  J.  Moore,  he  certainly  deserves  some 
praise  for  the  pleasant  manner  in  which  he  has  treated  the  subject, 
but  much  more  for  the  candour  he  has  shown.  I  must  do  him 
the  justice  to  point  this  out,  least  the  Reader,  seduced  by  his 
pleasantry,  should  suft'er  himself  to  misconstrue  the  Author's 
intentions. 

"I  cannot,  however,  discover  in  Mr.  J.  Moore's  pamphlet,  any 
answer  to  the  arguments  of  Mr.  Rogers,  or  any  thing  like  a 
reply  to  the  five  questions  in  my  printed  Letter.  A  particular 
reply,  indeed,  I  was  not  to  expect,  for  he  chuses  to  unite  all  the 
writers  against  Vaccination  in  one  class,  as  if  he  wished  that  a 
censure  applicable  to  any  one  of  them  individually  might  attach 
to  them  all  generally.  As  I  do  not  approve  this  method,  which  is 
unfair  and  sophistical,  I  shall  not  follow  it,  neither  will  I  pay  his 
ingenuity  so  bad  a  compliment  as  to  couple  him  with  Mr.  Ring, 
to  whom,  perhaps,  Mr.  Squirrel  is  a  more  than  equal  antagonist. 

"Mr.  Moore,  in  the  beginning  of  his  book,  for  what  reason  I 
cannot  discern,  pays  a  studied  compliment  to  the  humanity  of  the 
Faculty  of  Medicine  at  the  expence  of  Surgeons.  But  he  must 
allow  me  to  say,  it  is  the  peculiar  boast  of  Surgery  to  have  softened 
the  malignity,  and  to  have  discovered  the  cure  of  two  of  the 
greatest  evils  that  afflict  mortality,  in  the  judicious  practice  of 
Inoculation  and  by  the  improved  treatment  of  Lues  Venerea. 

"Surgery  has  positive  grounds  to  rest  upon,  which  will  for  ever 
secure  to  it  the  gratitude  and  the  support  of  mankind;  if  it  ever 
should  lose  any  part  of  its  due  estimation,  this  will  be  owing  to  the 
unwarrantable  presumption  of  some  who  practise  it  without  being 
properly  educated  in  its  principles. 

"  Every  Apothecary's  journeyman,  lectured  for  six  months  to 
pass  an  examination  for  the  lower  ranks  of  the  Army  and  Navy, 
now  pretends  to  be  a  proficient  in  this  art. 


LTFE  AND  LETTERS.  209 

"The  fatal  consequences  that  result  from  uneducated  practitioners 
in  every  branch  of  medicine,  assuming  the  province  of  the  Surgeon, 
and  experimenting  on  Inoculation,  is  justly  depicted  in  the  Report 
of  the  Jennerian  Society.  Mr.  Moore  makes  the  same  observation, 
and  tells  us  that  the  results  from  this  general  practice  were  so 
different  to  the  accounts  of  Mr.  Jenner  and  his  friends  that  many 
experiments  were  set  on  foot  in  order  to  establish  a  permanent 
theory.  By  these  it  was  ascertained  that  Dr.  Jenner's  account 
of  the  origin  of  the  disease  was  unfounded,  and  untrue.  This 
was  a  distressing  circumstance  to  befal  the  great  Father  of  the 
Experiment,  as  he  was  called,  who  ought  certainly  to  have  been, 
morally  speaking,  sure  of  his  principle  of  action,  before  he 
ventured  to  propose  it  to  the  Public,  or  petition  Parliament  for 
a  reward  for  his  discoveries.  It  was  now  asked,  what  had  he 
discovered  ?  Wnat  had  he  recommended  ?  What  were  his 
principles  as  well  in  Theory,  as  Practice  ?  These  were  awkward 
questions  ;  to  answer  them  was  difficult :  therefore,  to  avoid  the 
perplexing  appeals  that  were  daily  made  to  him,  and  the  messages 
that  were  perpetually  sent  requesting  him  to  visit  untoward  cases, 
the  Doctor  retired  from  London.  Had  matters  gone  on  smoothly, 
the  Doctor  would  have  found  it  his  incerest  to  have  remained 
in  the  Metropolis. 

"  The  horrible  description  which  Mr.  Moore  paints  of  the  Con- 
fluent Small  Pox,  and  of  the  Lues  Venerea,  may  be  just :  but  as 
they  happily  are  not  often  seen,  if  ever,  where  proper  treatment 
can  be  procured,  and  will  be  followed,  they  stand  as  extreme 
cases,  on  which  the  rhetorician  may  declaim,  indeed,  but  from 
which  the  sound  reasoner  can  draw  no  conclusive  argument.  I 
see  not,  therefore,  what  Mr.  Moore  gains  to  his  cause  by  the 
description.  I  must  however,  thank  him  for  it,  as  he  thus  affords 
me  an  opportunity  of  saying,  that  it  is  the  pride  of  Surgery,  to 
have  reduced  the  mortality  consequent  on  the  first  of  these 
disorders,  to  one  in  a  thousand  ;  and  that  attendant  on  the  last, 
to  nearly  the  same  proportion. 

"  The  Natural  Small  Pox  might  almost  always  be  avoided,  if 
Inoculation  were  duly  performed  :  and  instances  of  persons  dying 
of  Lues  Venerea,  except  in  ill-conducted  Workhouses,  are  almost 
unknown  to  regular  Surgeons. 

VOL.   I.  14 


210  EDWARD  JENNER. 


"Mr.  Moore  asserts,  that  Vaccination  was  opposed  before  any 
facts  could  be  alleged  against  it.  But  in  so  early  a  stage  of  the 
business  as  when  before  the  Committee  of  the  House  of  Commons, 
I  brought  three  cases,  and  named /o;/r  others,  of  Small  Pox  follow- 
ing Vaccination.  Was  this  opposing  without  facts  ?  Nay,  it  was 
these  very  cases  that  taught  Dr.  Woodville,  what  he  had  mistaken 
for  an  Hybrid  Eruption,  was  real  Small  Pox  ;  and  which  made 
Mr.  Cline  acknowledge,  that  Vaccination  would  not  prevent  Small 
Pox,  where  the  patient  had  breathed  variolous  atmosphere. 

"  Our  Author  goes  on  to  relate  the  rapidity  with  which  Vaccina- 
tion was  spread  through  every  part  of  the  world.  That  the 
progress  of  Vaccination  was  rapid,  beyond  almost  belief,  I  readily 
admit  :  that  this  circumstance  is  a  proof  of  the  merits  of  the 
System  I  deny.  We  live  in  a  capricious  age  ;  an  age  that  is  fond 
of  believing  paradoxes,  and  of  grasping  at  novelty.  And  this 
alone  might  account  for  the  wonderful  avidity  with  which  the 
experiment  was  adopted.  But  there  were  other  causes  that  co- 
operated, and  I  have  alread}^  specified  them.  So  long  as  the 
liberty  of  the  Post  Office  was  allowed,  and  the  Press  was  in 
possession  of  the  Society,  had  their  scheme  been  more  objection- 
able than  it  is,  it  would  with  facility  have  been  at  home  propagated  ; 
and  as  for  the  Continent,  English  faith  stood  so  firm  there  about 
that  period,  that  any  thing  from  England  was  received  as  sterling. 
Yet  I  had  accounts  even  from  the  Continent,  very  different  to 
Mr.  Moore's  representation ;  accounts  which  lamented  the  too 
easy  faith  of  some  Hanoverian  parents,  whose  children  were  the 
victims  of  this  new  experiment. 

"  Mr.  Moore's  candour  begins  to  shew  itself  about  the  ninth 
page,  where  he  admits  this  Cow  Pox  to  be  erroneously  attributed 
to  that  gentle  Animal.  '  No  Cow  that  is  allowed  to  suckle  her 
own  Calf,  untouched  by  the  Milker,  ever  had  this  complaint.'  He 
concludes  therefore,  that  the  Vaccine  Disease  is  some  pollution, 
imposed  upon  the  harmless  Animal  by  contact  of  the  Milker. 
This  I  can  readily  believe  to  be  the  case.  We  do  not  understand 
indeed  by  what  law  of  Nature  the  corrupt  humour  of  an  human 
disease  acting  on  the  teats  of  an  harmless  animal,  can  generate  a 
new  disorder  ;  but  it  seems  to  be  the  only  rational  way  of  account- 
ing for  the  phccnomenon  ;    and   nothing   remains    for    us   but   to 


LIFE  AND  LETTERS. 


inquire  what  that  disease  is,  which  being  communicated  from  the 
Milker,  produces  the  Vaccine  Matter.  — Is  it  the  Itch?  the  Lues 
Venerea?  or  the  Small  Pox  itself? — It  evidently  must  be  some- 
thing common  among  the  lower  orders,  for  with  them  it  originates: 
I  could  almost  be  tempted  to  think  it  was  often  the  Itch. 

"A  man  applied  to  me  at  St.  Thomas's  Hospital  to  examine 
his  hand  and  arm,  which  were  full  of  ulcerations.  He  said  he 
belonged  to  a  milk  house  near  the  end  of  Kent-street ;  that  several 
of  the  milkers  were  in  the  same  condition  with  himself;  and  that 
most  of  the  cows'  teats,  belonging  to  the  house,  were  affected  m  a 
similar  manner ;  he  added,  he  had  been  told  it  was  Cow  Pox. 

"  As  I  had  not  been  accustomed  to  see  the  natural  Cow  Pox,  I 
asked  one  of  my  Pupils  from  the  country  what  he  thought  of  the 
case.  He  replied,  that  the  patient  exhibited  every  symptom  of 
having  the  itch,  in  that  stage,  which  is  commonly  called  the  Rank 
Itch.  On  farther  examination,  the  appearance  about  the  fingers 
confirmed  his  observation  ;  I  directed  the  man  to  use  Jackson's 
Itch  Ointment,  and  he  appeared  again  at  the  end  of  a  week,  quite 
cured. 

"  From  this  accidental  circumstance,  and  from  the  tormenting 
itching  which  some  children,  when  vaccinated,  are  afflicted  with, 
it  will  be  worth  while  for  the  Committee  to  inquire  whether  the 
itch  may  not  be  one  of  the  diseases  that  form  the  base  of  the 
Vaccine  Matter. — At  all  events,  since  the  Cow  is  proved  innocent, 
and  the  Milker  alone  guilty,  it  will  be  proper  to  ascertain  w^hat  the 
complaints  are,  to  which  the  Milkers  in  Glostershire,  and  in 
Holstein  are  liable. 

"  Dr.  Jenner's  theory  of  the  grease  of  the  horse  is  now  given 
up,  even  by  his  best  friends  :  but  surely,  it  is  time  either  for 
himself  or  them  to  find  us  some  just  criterion,  that  may  enable  us 
to  distinguish  the  genuine  source  from  which  it  originates.  Why 
however  are  we  forbidden  to  inoculate  from  the  Cow  herself? 
Does  her  simple  food  increase  the  virulence  of  that  disease  with 
which  the  foul  milker  contaminates  her  teats  ?  or  again,  must  the 
disease  be  meliorated  by  passing  through  some  human  victim,  who 
is  perhaps  to  be  sacrificed  in  consequence,  before  it  can  be  fit  for 
general  use  ? 

What  the   Small    Pox  is,   we  know ;  and   we   know   also,  that 


EDWARD  JENNER. 


when  given  properly  by  Inoculation  it  will  communicate  a  mild 
disease  to  the  human  frame.  I  say  we  are  fully  acquainted  with 
the  benefits  and  the  management  of  that  meliorated  contagion  ;  a 
management  so  simple,  that  we  have  little  to  apprehend  even  from 
the  unskilfulness  of  ignorant  Practitioners ;  and  a  benefit  so 
unalloyed,  that  the  experience  of  now  near  a  century,  has  proved, 
that  the  use  of  it  does  not  contribute  to  swell  the  catalogue  of 
human  woes  by  new  disorders.  I  see  not  therefore  what  wisdom 
there  is  in  wishing  to  drop  Small  Pox  Inoculation  altogether  (for 
that  is  the  clamorous  demand  of  the  Jennerian  Society),  and 
inoculate  from  a  disease,  the  nature  of  which  we  know  not  :  a 
disease  so  varying,  and  so  ambiguous  in  its  appearance  and  effects, 
that  even  the  most  skilful  Vaccinator,  even  Dr.  Jenner  himself, 
who  has  proudly  suffered  himself  to  be  called,  '  The  man  destined 
to  expel  contagion,'!  cannot  be  certain  when  it  is  communicated, 
and  when  not  ;  when  it  is  genuine,  when  spurious  ;  a  disease  that 
has  already  given  suffering  mortality  a  new  malady,  which, 
whether  it  shall  be  called  the  Cow  Evil,  from  the  animal,  or  the 
Jennerian  Evil  from  the  inventor,  posterity  will  determine. 

"  But  why  do  I  say  the  inventor  ?  I  beg  pardon  of  this  '  expeller 
of  contagion,'  if  I  state,  that  the  Cow  Pox  has  been  known  for 
generations.  If  it  has  not  been  brought  forward  before,  the 
reason  is,  that  the  Physicians  of  former  days,  less  confident,  and 
less  empirick  than  some  of  the  present,  thought  it  unbecoming 
their  character,  and  what  they  owed  Society,  to  obtrude  any 
experiment,   which   they   were  not   fully  satisfied  was  a  salutary 

'  "  When  Dr.  Jenner' s  Bust  was  exposed  at  the  Exhibition  last  year,  it 
was  subscribed,  if  I  mistake  not,  with  the  following  lines  of  the  CEdipus 
Tyrannus  of  Sophocles. 

The  Man— 

By  great  Apollo's  high  command  ordain'd 
T'expel  the  foul  contagion  from  this  land  ; 
Nursed  there  too  long,  but  to  be  nursed  no  more. 

Dr.  J.  was,  T  understand,  wonderfully  pleased  with  the  application  ;  which 
certainly  was  very  ingenious,  and  only  wanted  truth  to  be  really  admir- 
able. If  a  second  Bust  were  to  appear,  I  apprehend  a  more  appropriate, 
though  less  splendid  motto  would  be 

Davus  sum,  non  CEdipus. 


LIFE  AND  LETTERS. 


one.  They  therefore  tried  it  in  silence;  they  found,  notwithstand- 
ing an  apparent  success  at  Hrst,  that  it  failed  ultimately,  and  they 
dropped  it.  I  shall  instance  no  other  name  than  that  of  Sir 
George  Baker,  who  had  Dr.  Jenner's  invention  mentioned  to  him 
forty  years  ago;  it  was  tried,  it  failed,  and  no  more  was  said  of  it. 
Mr.  John  Hunter  did  not  give  the  Experiment  much  credit.  The 
event  justifies  their  conduct :  for  surely  it  does  not  do  much 
honour  to  the  cause,  much  less  does  it  accord  with  the  positive 
assurances  given  Parliament,  for  Dr.  Jenner  to  lay  down  a  Theory, 
to  be  obliged  to  recant  it,  and  to  leave  the  Public  nothing  satis- 
factory in  its  place  :  it  does  us  nationally  no  great  honour  to  have 
the  Cow  Pox  make  so  much  noise  all  over  the  world,  and  then  to 
be  declared  no  Cow  Pox  :  neither  does  it  argue  much  in  favour  of 
the  wisdom  of  the  Faculty,  to  adopt  so  blindly  a  practice,  which 
the  first  Leaders  seem  to  know  nothing  about  after  seven  years 
experience,  except,  that  it  fully  contradicts  the  evidence  they 
produced  in  the  House  of  Commons  in  its  favour. 

"It  is  allowed  by  all  the  writers  among  the  Vaccinists,  that 
from  the  Cow  is  to  be  got  a  genuine  and  a  spurious  matter.  I 
cannot  understand  this  doctrine;  it  seems  contrary  to  the  general 
Laws  of  Nature  ;  she  has  given  us  a  genuine  but  no  spurious 
Small  Pox  ;  a  genuine  but  no  spurious  Measles.  More  merciful 
in  her  operations,  than  Vaccinators ;  she  gives  us  a  specific  evil, 
that  we  may  know  how  to  administer  specific  remedies  ;  and  when 
we  may  be  securely  freed  from  the  dread  of  its  recurrence. 

"  But  since  a  genuine  and  a  spurious  Cow  Pox  is  admitted  by 
Vaccinists,  how  do  they  account  for  it  ?  'Till  wiser  heads  than 
mine  have  determined  this  point,  I  will  suggest  the  following 
conjecture  : — 

"  It  is  allowed  on  all  hands,  that  Cow  Pox  is  generated  by  some 
disorder  imparted  by  the  milker.  Now  if  that  disorder  should 
happen  to  be  the  Small  Pox,  then  the  Pustule  so  occasioned,  and 
the  matter  coming  from  it,  may  inoculate  Small  Pox,  and  the 
patient  thus  inoculated,  may  be  for  ever  secure  from  that  disease, 
for  in  fact  he  will  have  received  Small  Pox  Inoculation.  But  if 
the  disorder  generated  on  the  Cow's  teats,  have  for  its  base.  Itch, 
as  I  apprehend  has  sometimes  happened,  then  the  patient  will  be 
inoculated  with   a  disorder,    which,    though  it  may  suspend  the 


214  EDWARD  JENNER. 


capacity    for    Small    Pox    for    a    season   in    the  constitution,   will 
ultimately  prove  no  security. 

"Notwithstanding  Mr.  Moore's  pleasant  way  of  treating  the 
subject,  he  cannot  laugh  away  this  simple  argument. 

"  If  there  is  no  such  disease  belonging  to  the  Animal  as  Cow 
Pox,  if  she  must  be  subject  to  infections  from  the  hand  of  him  to 
whom  she  spares  her  milk,  and  sacrifices  her  calf,  let  us  be 
acquainted  with  the  nature  of  these  infections,  and  do  not  let  us  so 
inhumanly  submit  our  babes,  while  smiling  in  the  mother's  face, 
to,  we  knoiv  not  what ! 

"  In  the  Sma  1  Pox,  and  other  infectious  disorders,  I  repeat,  we 
know  of  nothing  spurious  ;  the  matter  inoculated  from  a  patient 
who  may  die  afterwards  of  the  Confluent  Small  Pox,  will  produce 
nothing  but  a  mild  disease  ;  nothing  but  Small  Pox. 

"  When  the  Societies  quarrelled,  and  parted,  they  were  almost 
upon  the  point  of  declaring,  that  one  was  the  genuine,  the  other 
the  spurious,  Society  for  exterminating  the  Small  Pox.  This 
would  have  been  a  death  blow  to  the  whole  system.  The  friends 
of  both  parties  saw  this ;  an  accommodation  was  effected  :  like  the 
contending  heroes  on  the  stage,  they  said,  ^^  Brother,  Brother,  we 
are  both  in  the  wrong;  "  they  shook  hands,  and  agreed  at  all  events 
to  support  the  Experiment. 

"  I  shall  not  take  notice  of  that  part  of  our  Author's  pamphlet 
which  attacks  the  Physicians ;  not  only  because  I  conceive  it 
beside  my  immediate  subject,  but  because  I  consider  '  The  Com- 
mentaries on  the  Cow  Pox,'  lately  published  by  Dr.  Moseley,  to 
contain  a  full  answer  to  all  that  Mr.  Moore  has  asserted  on  this 
head. 

"  Those  pages  which  are  employed  in  describing  the  nature  of 
Small  Pox,  and  other  infectious  diseases,  are  well  worth  attending 
to;  though  they  are  written  with  such  affectation  of  wit,  that  if 
hastily  perused,  they  may  be  mistaken. 

"  However,  I  admire  Mr.  Moore's  candour,  as  I  collect  from  these 
pages,  that  he  is  of  opinion  the  Small  Pox  cannot  be  twice  received ; 
and  observe,  that  he  admits  some  cases  to  have  occurred,  where 
the  Small  Pox  has  appeared  on  persons  who  had  apparently  passed 
through  the  Cow  Pox,  in  a  regular  way.  He  then  concludes,  '  A 
true  Philosopher  knows  there  is  no  real  exception  to  the  Laws  of 


LIFE  AND  LETTERS. 


215 


Nature  ;  apparent  deviations  are  common,  but  the  Laws  of  Nature 
are  immutable.'  And  again  he  observes,  'If  Medical  men  were  as 
ready  to  own  their  errors  as  Chemists,  they  would  not  so  often 
accuse  Nature  of  being  so  capricious  as  thc}^  do. 

"  '  To  admit  that  a  few  individuals  organised  like  others,  are 
susceptible  of  having  certain  diseases  twice,  while  the  flood  of 
mankind  can  only  have  them  once,  is  almost  a  contradiction  in  the 
uniformity  of  the  Laws  of  Cause  and  Effect.' 

"  These  are  sentiments  so  just  in  themselves,  and  conceived  in 
such  a  spirit  of  candour  and  liberality,  that  although  Mr.  Moore 
discovers  sometimes  a  little  flippancy  of  wit  he  had  better  have 
spared,  and  although  he  sometimes  deals  too  much  in  authoritative 
assertion  which  does  not  sit  well  on  him,  I  nevertheless  sincerely 
wish  he  had  been  employed  earlier  in  the  controversy :  the 
question  then  probably  would  have  been  more  easily  decided. 

"  I  lament,  however,  that  he  will  not  suffer  his  own  principles 
to  produce  with  himself  that  conviction  1  apprehend  they  ought. 

"  If  a  true  philosopher  knows  there  are  no  real  exceptions 
to  the  Laws  of  Nature,  then  a  patient  cannot  have  the  Small  Pox 
twice.  But  Mr.  Moore  admits  that  patients  have  had  the  real 
Small  Pox  after  Vaccination  ;  the  disease  therefore  which  the 
Vaccine  matter  excited,  could  not  have  been  Small  Pox ;  and 
consequentl}',  those  patients  (except  in  the  cases  suggested  in 
page  45)  remain  liable  to  it,  as  soon  as  the  suspending  power 
of  the  Vaccine  disease  shall  have  ceased. 

"  This  argument  is  so  simple  a  one,  and  the  conclusion  in  my 
mind  so  just,  that  I  feel  confident  its  force  must  be  felt  by  every 
impartial  person. 

"  What  Mr.  Moore  says  of  the  primary  and  secondary  Small 
Pox,  in  which  all  sound  Practitioners  will  readily  concur  with 
him,  proves  everything  I  could  wish  in  favour  of  my  argument. 

"  Whoever  has  read  the  Report  of  the  Committee  of  the  House 
of  Commons,  would  conclude  from  the  multitude  of  evidence  there 
adduced,  that  the  practice  of  Vaccination  was  at  that  time 
perfectly  settled  and  understood.  But  Mr.  Moore  informs  us, 
'All  the  peculiarities  of  this  curious  complaint  were  not  detected 
at  once.  In  the  first  two  or  three  years  it  was  not  to  be  expected 
that  the  Art  of  Vaccination  should  be  brought  to  perfection.     It 


2i6  EDWARD  JENNER. 


is  therefore  not  to  be  wondered  at,  if  among  the  multitude  of 
Surgeons,  Apothecaries,  Clergymen^  and  Ladies,  who  practised, 
a  few  mistakes  have  happened.' 

"  That  no  experiment  is  perfected  at  once,  even  where  the 
principles  are  just,  I  readily  allow  :  it  is  no  more  than  what  must 
be  expected  from  the  imperfection  of  human  wisdom.  What  I 
complain  of,  is,  that  while  Vaccination  was  nothing  more  than  an 
experiment  it  should  have  been,  not  merely  recommended  to  the 
public  notice,  but  authoritatively  imposed  on  the  pubhc  practice. 
If  it  should  be  argued  that  Inoculation  was  urged  with  nearly 
as  much  earnestness  ;  I  shall  reply  that  the  cases  are  altogether 
different.  Inoculation  when  brought  into  England  was  no  longer 
a  mere  experiment :  it  was  a  practice  confirmed  by  the  experience 
of  generations  in  foreign  countries  ;  and  as  the  laws  of  Nature 
could  not  be  supposed  to  be  different  here,  and  in  Turkey,  the 
opposition  made  to  Inoculation  might  be  fairly  said  to  have  been 
the  result  of  ignorance,  and  prejudice. 

"  I  must  be  permitted  however  to  observe,  in  answer  to  Mr. 
Moore's  statement,  that  among  the  multitude  of  Surgeons,  hardly 
any  of  the  Court  of  Assistants  of  the  College  are  to  be  found. 
That  Parliament  should  have  omitted  to  consult  the  College  of 
Surgeons,  seems  to  me  an  oversight  hardly  to  be  accounted  for. 
As  Parliament  could  not  be  supposed  to  act  from  any  knowledge 
of  their  own ;  the  merits  of  the  case  not  depending  on  the  science 
of  politics,  or  legislation,  but  on  that  of  surgery  and  medicine, 
common  prudence  should  have  dictated  the  propriety  of  consulting 
the  Colleges  of  these  two  professions,  who  might  be  supposed 
competent  to  give  them  the  information  they  wanted.  When  the 
College  of  Physicians  were  applied  to,  they  gave  a  negative 
answer.  Had  the  College  of  Surgeons  been  consulted,  they 
would  have  discovered  a  truth,  which  has  not  yet  been  revealed. 
.The  only  surgeons  of  that  court,  whose  names  appear  in 
the  Report  of  the  Jennerian  Society,  are  Mr.  Ford  and 
Mr.   Home. 

"But  the  apothecaries  are  men  of  experience;  how  came  their 
multitudes  to  join  so  readily  in  the  experiment  ?  Why,  they  came 
into  the  new  practice,  because  they  early  discovered  it  was  the 
plan  of  the   men-midwives  to  seclude   them,  by  this  manoeuvre 


LIFE  AND  LETTERS.  2i-j 

from  the  nurseries  ;  and  finding  they  could  not  fight  them  fairly 
on  their  own  ground,  they  resolved,  by  forming  an  alliance,  to 
share,   if  possible,  the   conquest. 

"  The  co-operation  of  the  Clergy  (I  speak  of  those  of  the 
Established  Church,  and  I  speak  of  them  with  that  reverence  due 
to  so  learned,  and  so  respectable  a  body),  may  be  accounted  for, 
from  that  solicitude  to  benefit  the  bodies,  as  well  as  the  souls  of 
men,  which  forms  part  of  the  ministerial  character.  I  think 
however  that  they  would  have  done  wiser,  to  have  waited  till  the 
experiment  was  so  firmly  established  that  they  could  not  have 
stood  committed  by  any  subsequent  failure  ;  for  in  proportion  to 
the  sacredness  of  any  character,  ought  to  be  the  scrupulous  desire 
of  avoiding  what  might  expose  it  to  censure. 

"  As  for  Sectarian  preachers,  whether  in  or  out  of  the  church, 
they  saw  it  was  an  easy  way  of  securing  acceptance  to  their 
peculiar  tenets,  by  stealing,  under  the  specious  appearance  of 
Charity,  and  Philanthropy,  into  the  bosom  of  maternal  tenderness  ; 
while  the  tender  sex,  who  from  innate  benevolence  are  ever  ready 
to  assist  in  doing  good,  were  flattered,  were  soothed,  and  were 
instructed,  '  to  insinuate  the  plot  into  the  boxes.'  Dr.  Jenner 
took  so  much  pains  to  teach  some  ladies  to  vaccinate  with  a  light 
hand,  that  one  of  them  declared  she  only  brought  blood  from  two 
in  the  village  ;  and  that  cnly  one  family  among  her  patients  had 
shewn  any  symptom  of  the  Cow  Pox  disorders. 

"  Mr.  Moore  tells  us  that  all  the  misfortunes  have  happened 
about  Chelsea,  and  in  London  ;  and  that  there  has  hardly  been  a 
suspicion  of  any  failures  in  opulent  families. 

"  There  is  something  very  insidious  and  unjust  in  these  asser- 
tions ;  they  afford  almost  the  only  instance  of  disingenuous 
reasoning  to  be  found  in  Mr.  Moore's  book.  By  stating  the 
failures  to  have  occurred  round  Chelsea,  1  presume  he  aims  at  one 
of  the  opposers  of  Vaccination,  whose  practice  lying  much  in  that 
part  of  the  country,  if  it  could  be  shewn  that  no  cases  came  from 
other  quarters,  he  would  infer  that  those  adduced  were  the 
result  either  of  the  want  of  candour,  or  want  of  skill  in  a  preju- 
diced individual  :  and  by  asserting  that  there  is  hardly  any 
suspicion  of  failure  among  the  opulent,  he  would  insinuate  that 
those  cases  instanced  from  among  the  poor  are  not  to  be  credited  ; 


2i8  EDWARD  JENNER. 

the  poor  not   having  the   means   of  contradicting,    what  may    be 
asserted   of  them. 

"  To  the  first  of  these  insinuations  I  reply,  by  saying,  that 
there  are  few  parts  of  the  kingdom  from  which  I  will  not  pledge 
myself  to  bring  instances  of  failure  in  Vaccination,  as  notorious 
as  any  mentioned   in  the   vicinity   of  Chelsea,   and   London. 

"To  the  second  I  reply,  by  asserting  that  it  is  unfounded. 
There  is  a  degree  of  respect  due  to  the  superior  orders  of  society 
which  exacts  from  us,  when  speaking  of  them,  an  increased 
degree  of  delicacy.  To  proclaim  that  an  afflictive  malady  has 
befallen  an  individual  in  the  lower  orders  of  society,  can  be 
productive  of  no  great  inconvenience;  to  proclaim  the  same  of 
persons  who  perhaps  may  be  connected  with  some  of  the  first 
families  in  the  kingdom,  would  be  a  serious  evil.  I  think  Mr. 
Moore  therefore  highly  to  blame,  in  using  an  argument  which 
he  must  be  aware  from  a  sentiment  of  delicacy  could  never 
perhaps  be  answered  as  it  ought.  I  trust,  however,  I  am  not 
infringing  the  rule  I  wish  to  observe  when  I  say,  that  if  Dr. 
Jenner  were  again  to  apply  to  Parliament  for  support,  he  would 
find  from  many  members  of  both  Houses  that  marked  opposition 
to  his  pretensions,  which  would  prove  a  full  answer  to  this 
assertion  of  our  Author. 

"  Mr  Moore  acknowledges  one  benefit  to  have  arisen  from  the 
opposition  made  to  Vaccination,  namely,  the  improvement  of 
the  Practice ;  and  he  says,  a  little  more  time  will  dispel  the 
prejudices  of  the   inferior   Practitioners,    and   the  vulgar. 

"  If  the  lower  orders  of  society  have  conceived  prejudices 
against  Vaccination,  it  will  not  be  easy  to  root  them  out ;  for  not 
only  do  they  know  from  sad  experience  that  it  does  not  answer ; 
but  they  have  been  so  ungenerously  deceived  and  imposed  on  by 
the  Inoculators  at  the  Small  Pox  Hospital,  and  other  places, 
where  Cow  Pox  was  inserted  when  they  were  told  they  were 
to  be  inoculated  with  Small  Pox,  that  they  do  not  know  where  to 
put  their  trust.  This  is  such  an  instance  of  bad  faith,  as,  I  hope, 
will  never  occur  again  ;  every  principle  of  humanity  revolts 
against  it.  Was  it  not  sufficient  to  have  had  recourse  to  every 
possible  means  of  perverting  the  judgment  of  the  poor  by  every 
artifice  ingenuity  could  suggest,  but,  when  still  unconvinced  of  the 


LIFE  AND  LETTERS.  219 

efficacy  of  Vaccination,  they  demanded  to  be  inoculated  with 
Small  Pox,  must  they  be  systematically  deceived?  and  implicitly 
relying  on  the  honour  of  the  Operator,  must  they  be  clandestinely 
contaminated  with  the  very  disease  they  were  anxious  to  avoid  ? 

"  ' Speak  it  in  whispers  lest  a  Greek  should  hear  ! 

Lives  there  a  man  so  dead  to  fame,  who  dares 
To  think  such  meanness,  or  the  thought  declares  : 
And  comes  it  ev'n  from  him,  whose  Sov'reign  sway 
The  banded  Legions  of  all  Greece  obey  ?  ' 

"  Mr.  Wachsel  I  have  understood  is  not  to  be  blamed  for  this 
imposition  on  their  good  faith  ;  he  is  but  a  servant  of  the  charity, 
and  must  follow  orders.  Where  do  these  orders  originate  ? 
Who  is  to  blame  ?     Let  us  know  where  to  fix  the  stigma.  ' 

"  It  has  been  asserted,  that  more  children  have  died  within 
the  last  twelve  months  of  Small  Pox,  than  in  an}^  former  year  : 
and  from  this  circumstance,  an  argument  has  been  raised  to 
discredit  Inoculation  :  but  in  my  mind  a  conclusion  exactly 
opposite  ought  to   be  drawn   from   it. 

"  If  the  fatality  of  Small  Pox  has  been  greater  during  the 
last  year,  than  for  several  years  preceding,  this  is  owing  to  the 
suspension  of  Inoculation,  having  left  more  subjects  open  to 
its  infection.  For  many  with  whom  the  suspending  power  of 
Vaccination  had  subsided,  fell  unsuspecting  victims  to  the  Natural 
Disease  :  and  many  others  perished  by  it,  who  had  been  left 
open  to  its  attack,  because  their  parents  justly  objected  to  the 
unfair  proceedings  of  those  Practitioners  who  substituted  Cow 
Pox  for  Small  Pox  ;  and  having  thus  lost  all  confidence  in  the 
integrity  of  the  Faculty,  and  not  knowing  whom  to  trust,  they 
suffered  the  natural  disease  to  take  its  fatal  course. 

"  Let  us  put  things  upon  the  old  footing ;  let  us  drop 
Vaccination  altogether  for   seven  years,  and   practise  only  Small 

'  "Small  Pox  Hospitals,  if  properly  conducted,  appear  to  me  such 
useful  charities  in  a  great  Metropolis,  that  I  could  wish  to  see  them  main- 
tained even  at  the  public  expence  ;  since  from  such  Institutions,  ever}- 
Parish  might  be  supplied,  at  stated  periods,  with  proper  Medical  men,  who 
should  inoculate  the  poor  gratis.  By  this  means,  and  by  compelling  the 
parents  to  abstain  from  public  exposure,  the  evils  of  Natural  Small  Pox 
would  in  a  short  time  be  easily  subdued. 


220  EDWARD  JENNER. 

Pox  Inoculation,  and  if  the  mortality  in  Small  Pox  do  not  return 
to  its  old  standard,  I  will  be  content  to  give  up  my  opinion,  and 
become  as  devout  a  worshipper  of  the  Cow,  as  any  idolater 
within  the  realms  of  Hindostan,  or  the  precincts  of  Salisbury 
Court. 

"That  there  always  has  been  a  mortality  attendant  on  Small 
Pox,  even  when  Inoculation  alone  was  adopted,  no  one  can 
deny.  I  deny  however,  that  this  mortality  ever  has  been  as 
great  as  Mr.  Moore  asserts,  or  as  the  friends  of  Vaccination, 
eager  to  establish  their  own  system  by  discrediting  the  other, 
have  wished  to  make  the  Public  to  believe.  But  what  makes 
more  to  the  argument  is,  that  it  will  be  easy  to  point  out  the 
flagrant  error  to  which  the  mortality  may  be  referred  :  namely, 
the  public  exposure  of  patients  during  the  eruptive  state  of  the 
disorder.  A  common  error,  which  has  been  made  use  of  to 
raise  a  prejudice  against  Inoculation,  but  which,  so  far  from 
forming  a  necessary  part  of  the  treatment,  has  been  expressly 
forbidden  by  that  able  and  successful  Practitioner,  Baron  Dims- 
dale.  I  cannot  help  therefore  humbly  suggesting,  that  the 
Legislature  would  do  well  thus  far  to  interfere,  and  by  prohibiting 
under  penalty  such  improper  exposure,  remedy  an  evil,  which 
otherwise  society  must  continue  to  suffer  from  the  ignorance,  or 
perversity  of  unskilful  Practitioners. 

"  The  last  objection  I  shall  notice  is  one  on  which  it  seems 
to  have  been  the  aim  of  Vaccinators  to  lay  great  stress,  viz. 
that  what  is  called  the  King's  Evil,  generally  takes  its  rise  from 
Inoculation  :  this  is  particularly  depicted  in  some  of  the  engravings 
of  that  disgraceful  production  I  have  mentioned  in  a  former 
page,  '  The  View  of  the  Comparative  Effects  of  Inoculation,  and 
Vaccination.' 

"  I  shall  answer  this  assertion,  not  by  entering  into  any 
discussion  on  the  nature  of  Scrophula  in  general;  to  do  this 
satisfactorily  1  should  be  obliged  to  swell  my  pamphlet  beyond 
tlie  size  calculated  for  general  circulation  ;  but  by  simply  adducing 
matters  of  fact :  a  mode  of  arguing  to  plain  and  unsophisticated 
minds  always  the  most  agreeable,  and  certainly  the  most 
conclusive. 

"  I    must   therefore    remind    Mr.    Moore,  and   the  partisans   of 


LIFE  AND  LETTERS. 


Vaccination,  that  Scrophula  was  far  more  prevalent  before,  than 
after  tlie  introduction  of  Inoculation. 

"  Who  now  ever  hears  of  crowds  of  people  flocking  from 
the  most  distant  counties  to  be  cured  by  the  supposed  virtue 
of  the  Royal  Touch  ?  Who  now  sees  those  pieces  of  gold, 
which  in  the  reign  of  King  James  the  First,  and  long  after,  were 
suspended  so  generally  as  amulets,  endued  with  sovereign  power 
to  cure  the    Evil  ? 

"But  this  I  shall  be  told  is  only  a  presumptive  argument. 
I  grant  it :  a  more  positive,  one  is,  that  I  could  adduce  several 
large  families  of  children,  where  this  glandular  complaint  has 
for  generations  been  acknowledged  to  be  hereditary,  who,  having 
been  all  regularly  Inoculated  by  able  practitioners,  have  grown 
up  to  full  maturity  without  suffering  from  Scrophula,  or  so  much 
as  ever  exhibiting  symptoms  of  this  disorder. 

"  I  have  now  noticed  all  that  Mr.  Moore  has  brought  forward 
in  any  shape  relevant  to  the  question ;  and  the  result  is,  that 
I  am  still  more  than  ever  convinced  of  the  propriety  of  adhering 
to  those  opinions,  I  from  the  first  entertained,  of  the  inefficacy 
of  Vaccination. 

"  I  am  willing  to  pay  this  Author  the  compliment,  that  if  the 
cause  could  have  been  defended  satisfactorily,  it  would  have 
been  so  defended  b}^  him, 

"  '  Si  Pergama  dextra 
Defendi  possent,  etiani  hac  defensa  fuissent,' 

but,  my  conviction  is,  that  the  system  does  not  rest  on  any 
solid  foundation ;  that  it  never  can  stand.  For  let  us  candidly 
and  impartially  sum  up  all  that  has  been  established,  after  the  ex- 
perience of  now  above  seven  years  ;  let  us  compare  the  result,  with 
the  promised  advantages,  and  let  us  come  fairly  to  our  conclusion. 
"When  the  Committee  of  the  House  of  Commons  recom- 
mended Dr.  Jenner  to  the  munificence  of  Parliament,  it  was  for 
a  discovery  in  practice  which  was  never  to  prove  fatal ;  which 
was  to  excite  no  new  humours,  or  disorders  in  the  constitution  ; 
and  which  was  to  be,  not  only  a  perfect  security  against  the 
Small  Pox,  but  would,  if  universally  adopted,  prevent  its 
recurrence  for  ever. 


EDWARD  JENNER. 


*'  Here  then  are  three  distinct  points  on  which  Dr.  Jenner 
stands  pledged  to  give  the  pubHc  the  fullest  satisfaction  ;  other- 
wise, not  only  will  he  fail  in  his  part  of  the  contract,  but  the 
experiment  itself  will  fail  of  having  any  claim  to  public  notice 
or  support. 

"  Let  us  see  what  Dr.  Jenner  has  done  to  establish  the  justness 
of  his  several  positions  in  favour  of  Cow   Pox. 

"And  first  he  was  called  upon,  as  might  naturally  be  expected, 
to  give  an  account  of  the  origin  of  the  disease  itself. 

"  This  could  not  be  considered  as  a  difficult  task  ;  for  surely 
Dr.  Jenner  would  not  propose  to  inoculate  from  a  disorder 
without  knowing  what  that  disorder  was.  He  therefore  assured 
the  world,  that  it  originated  from  the  grease  of  the  horse's 
hf^el,  communicated  by  the  hands  of  the  milker  to  the  teats 
of  the  cow. 

"  This  theory,  which  in  itself  was  suspicious,  by  subsequent 
experiments  was  proved  to  be  erroneous  :  however  from  that 
hour  to  the  present,  Dr.  Jenner  has  been  able  to  advance  nothing 
satisfactory,  and  he  has  left  us  at  this  very  moment  in  the 
dark  as  to  the  real  nature  and  origin  of  the  Vaccine  Disease. 

"  But  though  Dr.  Jenner  could  not  tell  us  what  the  Cow  Pox 
was,  he  soon  came  forward  to  inform  us  that  it  was  of  two 
sorts,  the  one  genuine,  and  harmless,  the  other  spurious,  and 
hurtful. 

"  This  was  a  discovery  so  much  the  more  alarming  as  at  the 
same  time  no  criterion  but  the  eftect  was  given,  by  which  the 
two  sorts  could  be  distinguished.  Here  then  was  a  direct 
failure,  on  the  part  of  Dr.  Jenner  in  his  agreement,  if  I  may 
so  call  it,  with  the  Houses  of  Parliament. 

"  But  yet  further.  In  cases  where  Vaccination  did  not  produce 
fatal  consequences,  it  gave  rise  to  new,  and  painful  disorders. 
It  was  followed  sometimes  by  itchy  eruptions ;  sometimes  by 
singular  ulcerations,  and  sometimes  by  glandular  swellings  of  a 
nature  wholly  distinct  from  Scrophula,  or  any  other  known 
glandular  disease.  Here,  again,  was  a  failure  in  the  second 
point  stipulated  :  and  finally, 

"  It  was  ascertained  that  even  when  Vaccination  was  performed, 
from   what  was   called   the  genuine    matter,   it  would  not  always 


LIFE  AND  LETTERS.  223 

prove  a  preservative  against  the  Small  Pox  :  as  several  patients, 
who  had  been  pronounced  by  the  most  experienced  Vaccinators 
to  have  passed  regularly  through  the  Cow  Pox,  were  never- 
theless attacked  with  the  genuine  Small    Pox. 

"These  points  being  established,  and  they  are  established  by 
the  most  uncontested  facts,  facts  which  the  public  are  not  called 
upon  to  believe  on  the  assertions  of  those  who  oppose  Vaccina- 
tion, but  on  the  confession  of  those  who  support  it,  how  can 
Dr.  Jenner  be  said  to  have  fulfilled  what  he  stood  pledged  to 
Parliament  to  execute  ?  and  not  fulfilling  his  agreement,  how 
can  his  system  claim  reasonably  any  longer  its  support. 

"  Were  an  architect  to  undertake  to  build  an  edifice  which  he 
engaged  should  be  firm,  and  unshaken  in  its  foundations  ;  all  its 
rooms  wind  and  water  tight  ;  and  such  as  might  be  inhabited  with 
perfect  security  :  if  before  the  edifice  were  well  finished  the  foun- 
dations were  discovered  to  be  rotten  ;  and  if  in  less  than  seven 
years,  several  apartments  had  fallen  in  and  killed  those  who 
occupied  them,  while  in  a  great  number  of  rooms,  the  wind  or 
rain  was  perpetually  beating  in,  could  I  be  blamed  for  declaring 
that  the  architect  had  broken  his  contract,  and  that  the  edifice 
ought  to  be  no  longer  tenanted  ?  should  I  deserve  the  opprobrium 
of  acting  perversely,  and  disingenuously,  if  I  advised  my  friends 
not  to  quit  their  own  houses,  where  they  had  lived  securely  for 
generations,  to  occupy  apartments  where  they  could  never  be  free 
from  danger?  Certainly  not.  Every  body  would  say,  that  in 
giving  this  advice  I  was  acting  the  part  of  a  real  friend  !  Why 
then  am  I  to  be  told  I  am  acting  disingenuously,  or  perversely, 
when  I  remonstrate  against  the  general  practice  of  the  Cow  Pox  ? 
for,  such  an  edifice  as  I  have  described  above,  so  rotten  in  its 
foundation,  so  ill-built,  so  ruinous,  is  Vaccination. 

"  Has  the  conduct  of  the  friends  of  Vaccination  in  supporting 
and  recommending  their  system  been  such  as  to  impress  me  with 
a  favourable  opinion  of  the  system  ?  No  !  Their  conduct  has 
been  marked  with  so  much  art,  and  trick,  and  contrivance,  nay,  so 
much  deceit  has  been  resorted  to,  that  this  circumstance  alone 
would  make  me  suspect  the  goodness  of  the  cause  altogether,  and 
the  motives  that  influence  its  partisans. 

"Or  again,  have  the  writers  in  favour  of  Vaccination  been  able 


224  EDWARD  JENNER. 


to  produce  any  thing  that  has  operated  conviction  ?  Certainly 
not.  They  have  disproved  no  well  attested  fact :  they  have  con- 
fined themselves  for  the  most  part  to  raillery  and  contemptuous 
sneers  at  their  opponents  ;  and  the  Jennerian  Society  itself,  when 
it  publishes  a  report,  advances  such  unfounded  assertions,  and 
uses  such  equivocal  language  as  I  think  never  could  have  been 
employed  had  the  system  been  a  good  one. 

"  Why  then,  or  on  what  grounds,  am  I  to  come  into  the 
opinions  of  the  Jennerian  Society  ?  Is  there  any  thing  in  their 
conduct  that  can  prepossess  me  in  their  favour  ?  any  thing  in 
their  practice  to  recommend   them  ? 

"  But  arguments  may  be  fallacious — let  us  come  to  facts.  Can 
any  one  disprove  the  three  following  : 

"That  Vaccination  has  been  too  often  fatal  : 

"  That  Vaccination  has  introduced  new  disorders  into  the 
human  system  : 

"  That  Vaccination  is  not  a  perfect  security  against  the  Small  Pox. 

"These  facts  I  maintain  can  never  be  disproved. 

"  That  Vaccination  is  sometimes  fatal  may  be  shewn,  not 
vaguely  by  assigning  to  it  the  subsequent  death  of  the  patient, 
as  the  only  probable  cause,  but  from  destructive  inflammation 
which,  in  some  instances,  has  arisen  immediately  from  the  punc- 
ture of  Cow  Pox  Inoculation  ;  a  case  that  never  did  occur  in 
Small  Pox   Inoculation. 

"  That]Vaccination  introduces  new  disorders,  is  proved  from  a 
new  genus  of  disease,  unknown  to  any  former  practitioner ;  un- 
known till  after  the  introduction  of  the  Cow  Pox  :  and  never  to  be 
found  but  in  those  subjects  who  have  had  that  disorder. 

"That  Vaccination  is  not  a  perfect  security  against  the  Small 
Pox — ive  have  the  confession  of  the  Jennerian  Conimittee  itself. 

"  Let  these  facts  be  considered,  and  then  let  the  concluding 
sentence  of  the  report  of  the  Jennerian  Committee  be  read. 

"  How  after  all  that  has  been  established,  and  admitted,  can  it 
be  said  '  that  mankind  have  already  derived  great  and  incalculable 
benefits  from  the  discovery  of  Vaccination  ?  '  how  can  it  be  main- 
tained there  is  full  cause  for  believing,  that  Cow  Pox  Inoculation 
will  ultimately  succeed  in  extinguishing  the  Small  Pox  ? 

"  And   yet   this    conclusion    is    subscribed    by    a    list    of  many 


LIFE  AND  LETTERS.  225 


respectable  names.  I  really  could  almost  be  tempted  to  believe 
that  some  of  those  signatures  have  been  applied  further  than  was 
intended  :  and  that  there  are  those  among  the  subscribers,  who, 
only  wishing  to  encourage  the  experiment,  have  been  made  to 
appear  to  support  the  system. 

"  However  this  may  be,  one  thing  is  certain :  those  names 
convey  in  reality  only  the  opinion  of  so  many  practitioners. 
Now,  the  opinion  of  the  wisest  men  that  ever  lived,  if  in  opposi- 
tion to  facts,  must  be  erroneous,  and  consequently  of  no  authority. 
Besides  which  on  the  very  score  of  opinion,  something  ought  to  be 
taken  into  consideration. 

"  There  are  persons  in  the  list  whose  abilities,  whose  character, 
and  knowledge  I  revere ;  I  might  instance  Dr.  Baillie,  and  some 
others ;  but  there  are  those  among  them,  whose  abilities,  whose 
character,  and  knowledge  I  do  not  revere  :  whose  opinions  con- 
sequently, have  no  weight  with  me,  and  ought  not,  I  think,  to 
have  any  with  the  public. 

"These  then  are  the  grounds  on  which  I  feel  myself  justified  in 
adhering  to  the  opinion  1  first  declared  before  the  Committee  of 
the  House  of  Commons  ;  and  these  are  the  reasons  for  which  1  do 
not  hesitate  to  pronounce,  that  I  think  the  high  sanction  that  has 
been  given  to  the  Cow  Pox  Experiment,  as  well  from  the  Royal 
Name,  as  from  the  protection  of  Parliament,  ought  to  be  with- 
drawn :  for  that  sanction  is  deservedly  of  such  weight,  that 
remote  practitioners  do  not  even  give  the  subject  a  considera- 
tion, but  conclude  that  a  system  so  recommended  must  be 
unexceptionable. 

"  I  trust  it  will  not  be  supposed,  from  what  I  have  said,  that  I 
am  presuming  to  censure  either  that  August  Personage,  or  the 
Houses  of  Parliament,  for  the  support  they  have  afforded  the 
cause  of  Vaccination.  What  they  did  arose  from  that  parental 
solicitude  which  they  feel,  and  never  can  cease  to  feel,  for  the 
welfare  of  individuals,  and  the  happiness  of  the  community  :  and 
though  I  may  think  the  experiment  was  not  sufficiently  tried 
before  it  was  recommended,  still  they  did  but  exercise  that  prin- 
ciple, which  has  been  so  often  exerted  for  the  public  good  ;  and 
which  has  procured  us  blessings,  eminently  greater  than  any 
enjoyed  by  the  other  nations  of  the  world. 

VOL.   I.  I  5 


226  EDWARD  JENNER. 


"  That  Dr.  Jenner  should  have  been  remunerated  by  the  muni- 
ficence of  Parliament  I  conceive  to  be  no  more  than  just ;  on  this 
general  principle,  that  he  who  neglects  his  own  private  interests, 
in  order  to  promote  the  public  benefit,  has  some  claim  for  public 
compensation.  That  the  experiment  itself  should  have  been 
made,  I  likewise  think  wise ;  because  it  is  only  from  experiment 
that  we  can  ascertain  what  is,  or  what  is  not,  beneficial  to  society. 
But  I  can  neither  think  it  just,  nor  wise,  that  when  Vaccination 
has  failed  in  so  many  points  of  accomplishing  those  ends  it 
promised  to  accomplish  :  it  should  still  continue  to  receive  that 
degree  of  sanction  and  support,  which  a  completely  successful, 
and  unobjectionable,  practice,  alone,  is  entitled  to  enjoy." 

In  July  1806,  Lord  Henry  Petty  again  brought  the 
subject   of  vaccination  before  the   House. 

He  moved  the  following  address  to  his   Majesty  : — 

"  That  the  Royal  College  of  Physicians  should  be  requested  to 
inquire  into  the  progress  of  vaccine  inoculation,  and  to  assign  the 
causes  of  its  success  having  been  retarded  throughout  the  United 
Kingdom,  in  order  that  their  report  might  be  made  to  the  House 
of  Parliament,  and  that  we  may  take  the  most  proper  means  of 
publishing  it  to  the  inhabitants  at  large." 

Lord  Henry  Petty  was  of  opinion  that  if  the  result 
of  such  proposed  inquiry  resulted  (as  he  was  strongly 
disposed  to  think  it  would)  in  a  corroboration  of  the 
beneficial  effects,  which  other  nations  were  inclined  to 
regard  as  the  result  of  vaccine  inoculation,  it  would 
afterwards  be  for  the  House  to  consider  whether  a 
sufficient  reward  had  been  bestowed  on  the  original 
discoverer  of  vaccine   inoculation. 

The  Royal  College  of  Physicians  having  received 
their  commands,  applied  themselves  to  the  inquiry,  and 


LIFE  AND  LETTERS.  227 


corresponded  with  the  Colleges  of  Physicians  in  Dublin 
and  Edinburgh,  the  Colleges  of  vSurgeons  in  London, 
Edinburgh,  and  Dublin,  and  having  reported  in  lavour 
of  Dr.  Jenner,  the  question  of  a  further  grant  was  put 
to  the  House,  and  ^20,000  was  agreed  to  by  a  majority 
of  thirteen. 

The  subject  which  then  occupied  Jenner's  attention 
was  the  prohibition  of  Small  Pox  inoculation,  tor 
Raron  says, 

"  He  knew  that  vaccination  would  be  comparatively  powerless 
while  its  virulent  and  contagious  antagonist  was  permitted  to  walk 
abroad  uncontrolled." 

Jenner  had  an  interview  on  this  subject  with  the 
Minister,  Mr.  Perceval,  but  his  mission  was  unsuc- 
cessful. He  communicated  the  result  in  a  letter  to 
Dr.  Lettsom,  July    1807. 

"  Vou  will  be  sorry  to  hear  the  result  of  my  interview  with  the 
Minister,  Mr.  Perceval.  I  solicited  this  honour  with  the  sole  view 
of  inquiring  whether  it  was  the  intention  of  government  to  give  a 
check  to  the  licentious  manner  in  which  Small  Pox  inoculation  is, 
at  this  time,  conducted  in  the  metropolis.  I  instanced  the  mortality 
it  occasioned  in  language  as  forcible  as  I  could  utter,  and  showed 
him  clearly  that  it  was  the  great  source  from  which  this  pest  was 
disseminated  through  the  country,  as  well  as  through  the  town. 
But,  alas  I  all  1  said  availed  nothing ;  and  the  speckled  monster 
is  still  to  have  the  liberty  that  the  Small  Pox  Hospital,  the  delu- 
sions of  Moseley,  and  the  caprices  and  prejudices  of  the  misguided 
poor,  can  possibl}'  give  him.  I  cannot  express  to  3'ou  the  chagrin 
and  disappointment  I  felt  at  this  iiiterview." 

The    State    having   been   committed    to   the  policy  ot 


228  EDWARD  JENNER. 

supporting  vaccination,  tlie  Government  was  now  called 
upon  to  found  an  establishment,  in  place  of  the  Royal 
Jennerian  Institution,  which  had  almost  collapsed,  from 
want  of  funds  and  from  bad  management.  Vaccination 
would  then  be  conducted  under  the  countenance  and 
support  of  Government,  and  employed  throughout  the 
empire.  ij 

Jenner  drew  up  a  plan,  and  prepared  an  estimate  of 
the  expenses.  The  illness  of  his  son  necessitated  his 
return  to  Berkeley,  but  the  warrant  for  instituting  a 
National  Vaccine  Establishment  was  obtained  in  his 
absence,  and  he  was  appointed  Director.  Jenner 
nominated  his  friend,  Mr.  Moore,  as  Assistant  Director, 
and  his  faithful  advocate,  Mr.  Ring,  as  Principal  Vacci- 
nator and  Inspector  of  Stations.  The  Board  assembled 
to  appoint  the  principal  officers,  and  Mr.  Ring  was  set 
aside  and  another  candidate  selected.  At  the  next 
meeting  of  the  Board  to  appoint  subordinate  officers, 
Jenner  sent  in  the  names  of  seven  whom  he  wished  to 
be  elected,  but  the  appointments  were  first  reduced  to 
six,  and  out  of  six  persons  nominated  by  Jenner,  four 
were   rejected. 

The  board  appointed  him  Director,  but  they  soon 
contrived  to  let  him  feel  that  he  was  a  "'Director 
directed^  The  danger  of  a  Director  with  the  patronage 
of  all  the  appointments  was  obvious,  for  the  public 
would  soon  have  lost  confidence  in  Reports  emanating 
from  a  ring  ot  officials  bound,   by  the  circumstances  of 


LIFE  AX  J)  LETTERS. 


12() 


their  appointment,  to  support  the;  credit  of  the  Institution 
and  of  Vaccination. 

Jenner,  however,  considered  that  he  had  been  very 
badly  treated,  and  wrote  to  Mr,  Moore: — 

"It  was  stipulated  between  Mr.  Rose,  Sir  Lucas,  and  myself, 
that  no  person  should  take  any  part  in  the  vaccinating  depart- 
ment, who  was  not  either  nominated  by  me,  or  submitted  to  my 
approbation,  before  he  was  appointed  to  a  station.  On  my  re- 
minding Sir  Lucas  of  this,  he  replied,  *  You,  Sir,  are  to  be  the 
whole  and  sole  director.  We  (meaning  the  board)  are  to  be 
considered  as  nothing :  what  do   zvc  know  of  vaccination  ?  " 

Under  these  circumstances,  Jenner  felt  himself  obliged 
to  withdraw  from  the  establishment,  although  his  friends 
thought  the  step  was  uncalled  for.  But  Jenner  was  not 
influenced  by  their  advice,  and  Mr.  Moore  was  therefore 
appointed  in  his  place. 

Jenner  communicated  his  reasons  to  Mr.  Moore  in 
the  followincj  letter  : — 

From   Dr.  Jenner  to  J a:\iks  Moore,  Esq. 

"My  dear  Friend, — At  the  time  I  informed  you  of  my  intention 
to  come  to  town,  believe  me  I  was  quite  in  earnest.  But  while 
I  was  getting  things  in  order,  came  a  piece  of  information  from  a 
Right  Hon.  Gentleman  which  determined  me  to  remain  in  my 
retirement.  It  was  as  follows.  T/iat  the  Institution  was  fanned 
for  the  purpose  of  a  full  and  satisfactory  investigation  of  the  benefits 
or  dangers  of  the  vaccine  practice,  and  that  this  was  the  7'eason  ivhy 
Dr.  J.  could  not  be  admitted  as  one  of  the  conductors  of  it,  as  the 
puldic  ivouid  not  have  had  the  same  confidence  in  their  proceedings 
as  if  the  board  were  left  to  their  own  judgment  in  doubtftd  cases. 
This  is  the  sum  and  substance  of  the  communication ; — '  What 
do  we  know  of  Vaccination  ?     We  know  nothing  of  Vaccination.' 


230  EDWARD  JENNER. 


"  And  3'et,  my  friend,  these  very  ive  are  to  be  the  sole  arbi- 
trators in  doubtful  cases  !  Alas,  poor  Vaccina,  how  art  thou 
degraded  ! 

"You  intimated  something  of  this  sort  to  me  some  time  since, 
and  now  I  get  it  from  the  fountain  head.  An  institution  founded 
on  the  principle  of  inquiry  seven  or  eight  years  ago,  would  have 
been  worthy  of  the  British  nation  ;  but  now,  after  the  whole  world 
bears  testimony  to  the  safety  and  efficacy  of  the  vaccine  practice, 
I  do  think  it  a  most  extraordinar}^  proceeding.  It  is  one  that  must 
necessarily  degrade  me,  and  cannot  exalt  the  framers  of  it  in  the 
eyes  of  common  sense.  I  shall  now  stick  closely  to  uiy  own 
Institution^  which  I  have  the  pride  and  vanity  to  think  is  para- 
mount to  all  others,  as  its  extent  and  benefits  are  boundless.  Of 
this,  I  am  the  real  and  not  the  nominal  director.  I  have  conducted 
the  whole  concern  for  no  inconsiderable  number  of  years,  single 
handed,  and  have  spread  Vaccination  round  the  globe.  This 
convinces  me  that  simplicity  in  this,  as  in  all  effective  machiner}^, 
is  best. 

"I  agree  with  you  that  my  not  being  a  member  of  the  British 
Vaccine  Establishment  will  astonish  the  world ;  and  no  one 
in  it  can  be  astonished  more  than  myself.  An  establishment 
liberally  supported  by  the  British  Government, — its  arrangements 
harmonious  and  complete, — every  member  intimately  acquainted 
not  only  with  the  ordinary  laws  and  agencies  of  the  vaccine  fluid 
on  the  human  constitution,  but  with  its  extraordinary  or  anomalous 
agencies, — all  fully  satisfied  from  the  general  report  of  the  civilized 
part  of  the  world  and  their  own  experience  of  the  safety  and  efficacy 
of  the  vaccine  practice, — all  cordially  uniting  in  directing  that  prac- 
tice to  one  grand  point,  the  extermination  of  the  Small  Pox  in  the 
British  Empire: — a  society  so  formed,  was  a  consummation  devoutl}' 
to  be  wished.  But  instead  of  this,  taking  awa}'  yourself  and  a  few 
others,  an  assembly,  which  from  well-known  facts  must  appear 
discordant  in  the  eyes  of  the  public,  is  packed  together.  However, 
incongruous  as  it  is,  it  would  have  been  still  more  so,  had  I  mingled 
with  it;  and  what  is  above  all  other  considerations,  and  which 
would  have  proved  a  source  of  perpetual  irritation,  I  must  have 
gone  in  with  a  sting  upon  my  conscience. 

"  Though  resolved  on  not  incorporating  myself  with  the  Society, 


LIFE  AND  LETTERS. 


^i^ 


be  assured  I  shall  be  ever  ready  to  afford  it  any  assistance  in  m\' 

l)Ower. 

"  Believe  me,   my  dear  Friend, 

"  Most  truly  yours, 

"  Edward  jEiNNER. 
"  Berkeley, 

''April  d,th,   1809." 

Jenner  had  also  turned  his  attention  to  the  prevention 
of  chstemper  in  dogs.  Having  successtully  inocuhited 
dogs  with  Cow  Pox,  he  concluded  that  they  would  be 
thereby  protected  from  distemper,  and  several  t"ox- 
hunters  availed  themselves  of  the  suggestion,  and  had 
their  hounds  vaccinated.  Together  with  his  nephew, 
George  Jenner,  he  vaccinated  about  twenty  of  his 
Majesty's  staghounds.  But  in  this  year,  1809, 
Jenner  seems  to  have  abandoned  the  idea,  for  he  pub- 
lished a  paper  on  distemper  in  the  Mcdico-Chirurgical 
Transactions^  and  omitted  any  reference  to  the  effects 
of  vaccination.  Baron,  however,  believed  that  the  pro- 
tective influence  was  established,  and  relates  that  a 
friend  of  Dr.  Jenners,  Mr.  Skelton,  a  sporting  gentle- 
man  in    Yorkshire,    made  some    "very   decisive"   trials. 

"  Having  selected  three  couples  of  health}^  pups  of  six  weeks 
old,  I  inoculated  three  of  them  with  the  Cow  Pox  under  the  left 
arm,  a  little  above  the  elbow,  which  regularly  matured.  The. 
other  three  w'ith  those  inoculated  were  sent  out  to  quarters.  At 
a  proper  age  they  were  all  brought  to  the  kennel.  The  former 
with  other  hounds  were  soon  attacked  with  and  died  of  the 
distemper,  whilst  the  latter  remained  perfectly  healthy,  though 
surrounded  by  their  infected  companions,  becoming  the  strongest 
hounds  in   the  pack,  and   having  certainly  the  best  noses." 


EDWARD  JENNER. 


Jenner    was    also    much    interested    in    the    treatment 

of  hydrophobia.      He  corresponded   with   the    Rev.   Dr. 

Worthington  on  this  subject : — 

"  Berkeley,  /\th  Alay,  1810. 
"  My  Dear  Sir, — I  have  been  favoured,  since  my  last  dispatch 
to  Southend,  \vith  your  neat  little  essay  on  Vaccination  and  your 
observations  on  dipping.  Have  you  seen  an  account  of  some 
bold  Vaccine  transactions  now  going  forward  among  the  medical 
men  of  the  county  ?  Their  resolutions  appear  in  the  Gloucester 
and  Cheltenham  papers.  Your  county  I  hope  will  soon  follow 
this  laudable  example.  The  Small  Pox  will  never  be  subdued, 
so  long  as  men  can  be  hired  to  spread  the  contagion  by  inocula- 
tion. 

"With  regard  to  the  other  subject  you  mention,  be  assured  my 
thoughts  have  not  been  idle  upon  it,  having  lived  man  and  boy 
much  beyond  half  a  century  in  a  dipping  country.  Pyrton 
Passage,  four  miles  only  from  this  place,  has  been  noted  for  this 
practice  from  time  immemorial ;  and  true  it  is,  I  never  saw  or 
heard  of  a  single  case  of  hydrophobia  after  dipping  in  the  Severn, 
or  as  our  friend  Westfaling  has  it,  drowning  ;  for  so  it  is,  as 
you  shall  hear.  I  once  asked  a  long-experienced  professor  what 
length  of  time  he  kept  his  patients  under  water  ?  His  reply  was, 
'  As  to  that  I  can't  tell,  but  I  keep  them  under  till  they  have 
done  kicking,  when  I  bring  them  up  to  recover  their  senses,  and 
get  a  little  breath,  and  then  down  with  them  again,  and  so  on 
to  a  third  time,  observing  the  same  rule,  not  to  take  them  up 
till  their  struggle  is  over.' 

"  You  see  then  what  a  shock  the  vital  principle  receives  from 
this  process.  The  modus  operandi  let  us  not  trouble  our  heads 
about,  if  the  fact  can  be  established  that  it  deadens  the  action 
of  the  inserted  virus.  1  have  wished  to  see  how  far  it  can  be 
supported  by  analogy,  by  getting  some  vaccinated  patient  dipped 
^Vithin  a  few  days  after  the  insertion  of  the  vaccine  lymph.  At 
all  events  an  inquiry  so  highl}^  important  should  be  taken  up,  and 
it  cannot  be  in  better  hands  than  yours." 

A    montli    later,    Dr.    Worthington   appears   to    have 


LIFE  AND  'LETTERS. 


m 


encountered  a  failure,  and  communicated  the  informa- 
tion to  Jenner.  He  received  a  ready-made  explanation 
in  reply. 

"  I  told  Westfaling,  in  a  conversation  on  clipping,  that  there 
might  be  bad  dippers  as  well  as  bad  vaccinators,  for  which  there 
seems  at  present  to  be  no  allowance.  Pray  do  not  be  deterred 
from  prosecuting  your  inquiry.  He  also  proposed  a  trial 
with  snake  poison  as  an  antidote,  and  that  failing,  he  advised 
Vaccination. 

"  Yesterday  I  dined  with  Professor  Davy.  I  wish  you  had 
been  with  us.  His  mind  is  all  in  a  blaze.  He  seems  to  be  one 
of  those  rare  productions  which  nature  allows  us  to  see  once 
in  a  score  of  centuries.  We  touched  on  hydrophobia.  He 
started  an  ingenious  idea,  that  of  counteracting  the  effects  of  one 
morbid  poison  with  another.  What  think  you  of  a  viper  ? 
Not  its  broth,  but  its  fang,  as  soon  as  the  first  symptom  of 
disease  appears  from  cauination.  \{  this  should  succeed,  we 
must  domiciliate  vipers  as  we  have  leeches.  But  from  this  hint  I 
should  be  disposed  to  try,  under  such  an  event,  Vaccination  ; 
as  it  can  almost  always  be  made  to  act  quickly  on  the  S3'stem, 
whether  a  person  has  previously  felt  its  influence  or  not,  or  that 
of  the  Small  Pox. 

"  An  answer  to  one  of  your  questions.  I  am  sure  the  cuckoo 
has  nothing  to  do  with  hatching,  as  all  the  adults  are  off,  while 
a  great  number  of  their  eggs  remain  unhatched.  I  should  put 
dogs  quite  out  of  the  question  in  the  new  research,  and  confine 
myself  totally  to  the  human  animal ;  I  mean,  with  respect  to 
dipping." 

During  1809,  and  for  some  years  afterwards,  Jenner 
corresponded  with  Mr.  Moore,  supplying  him  with  details 
in  support  of  vaccination,  for  the  Reports  of  the 
National  Vaccine  Establishment  and  for  a  work  on 
the  subject. 


234  EDWARD  JENNER. 


To  James  Moore,  Esq. 

"  Dear  Moore, — Depend  upon  it  there  are  many  such  cases 
as  those  which  have  occurred  in  Mr,  Wingfield's  family  in  reserve 
for  us.  \^accination  at  its  commencement  fell  into  the  hands  of 
many  who  knew  little  more  about  it  than  its  mere  outline.  One 
grand  error,  which  was  almost  universal  at  that  time,  was  making- 
one  puncture  only,  and  consequently  one  vesicle ;  and  from  this 
(the  onl}^  source  of  security  to  the  constitution)  as  much  fluid 
was  taken  da}^  after  day  as  it  would  afford  :  nevertheless,  it  was 
unreasonably  expected  that  no  mischief  could  ensue.  I  have 
taken  a  world  of  pains  to  correct  this  abuse  ;  but  still,  to  my 
knowledge,  it  is  going  on,  and  particular!}^  among  the  faculty 
in  town.  Mr.  Knight's  cases  were  first  made  known  to  me  by 
Lady  Charlotte  Wrottesley.  This  lady  was  one  of  my  early 
pupils,  and  is  an  adept  at  vaccination,  as  thousands  of  her  poor 
neighbours  in  Staffordshire  can  testify.  She  saw  at  once  the 
true  state  of  the  children  in  question.  I  do  not  presume  to  say, 
that  these  children  are  examples  of  any  improper  practice  ;  they 
might  have  been  afitected  with  herpetic  eruptions  at  the  time  of 
vaccination,  which  are  so  apt,  without  due  attention,  to  occasion 
a  deviation  from  the  perfect  character  of  the  vaccine  vesicle.  I 
think  it  must  be  the  paper  on  this  subject  3'ou  allude  to  as  wishing 
to  see.  I  have,  therefore,  sent  it  to  3'ou  ;  and  a  copy  of  that 
paper  you  saw  in  manuscript,  on  secondary  variolous  contagion. 
If  you  should  want  an}^  more  of  the  latter,  you  may  draw  upon 
Gosnell  the  printer  for  them.  By  the  way,  it  might  be  right  to 
send  one  to  the  National  Vaccine  Establishment;  determine  this 
point  yourself.  Willan,  in  his  Treatise  on  Vaccination,  has  spoken 
much  to  the  purpose  respecting  Small  Pox  after  Cow  Pox  ;  you 
cannot  quote  a  better  author.  His  word  will  go  further  than 
mine,  as  he  must  be  supposed  to  be  less  interested.  I  do  not 
think  enough  has  yet  been  said  of  the  Small  Pox  after  supposed 
security  from  Small  Pox  inoculation.  Blair  told  me,  when  I  left 
town,  he  was  collecting  these  cases  with  a  view  to  publication. 
Thousands  might  be  collected  ;  for  every  parish  in  the  kingdom 
can  give  its  case.  I  fear  your  materials  for  the  year  are  more 
scanty   than  could  be   wished  for  your  Report ;  but  they  are   in 


LIFE  AND   LETTERS.  235 


good  hands  to  make  the  most  of.  Addington  will  not  be  an 
improper  addition  to  your  establishment.  He  has  talents ;  and 
Avill  be  always  ready  to  assist  you  with  his  pen  and  ink  when  you 
are  hurried." 

"  Berkelfa',  February  ibtJi,  1810. 

"  I  have  made  a  great  blunder,  it  seems,  in  my  reply  to  your 
inquiry  respecting  my  opinion  of  what  you  call  papulary^  eruptions 
after  Cow  Pox.  I  really  thought  you  alluded  to  that  appearance 
which  I  mentioned  ;  but  finding  myself  set  right,  I  have  no 
hesitation  in  saying,  that  what  Willan  has  said  on  this  subject 
is  correct.2  My  friend  Dr.  Parry,  of  Bath,  has  made  some 
interesting  observations  on  these  modifications  or  varieties  of 
variola  ;  and  I  am  sure  he  would  readily  furnish  you  with  them 
on  an  application  for  that  purpose.  Crcaser,  of  Bath,  could  also 
give  you  some  good  facts,  with  observations  on  the  same  subject. 

By   the   way,    have  you  his   pamphlet   respecting   P 's  bad 

conduct  ?  You  should  have  it.  I  have  myself  seen  but  one 
solitar}'  case  of  this  secondar}-  Small  Pox,  and  that  was  in  a  child 
of  Mr.  Gosling's  vaccinated  by  a  Mr.  Armstrong.  This  went 
tiirough  its  course  in  the  usual  rapid  wa}-. 

"  You  spoke  of  a  print  for  your  intended  work.  There  are 
several  about  the  town.  The  best,  I  think,  is  from  a  painting 
of  Northcote's,  done  some  years  since  for  the  Medical  Society  at 
Plymouth.  I  believe  this  is  rather  scarce;  but  j-ou  are  acquainted 
with  Northcote,  and  I  daresay  he  has  one  in  his  possession. 
When  I  was  last  in  town,  my  friends  urged  me  to  sit  to  Lawrence, 
and  I  complied.  If  you  approved  of  it,  and  he  had  no  objection, 
that  might  suit  you.  He  talked  of  getting  a  print  from  the  paint- 
ing for  himself.  It  will  never  do  for  me  to  go  to  the  pencil  now  ; 
for  if  my  countenance  represents  my  mind,  it  must  be  beyond 
anything  dismal. 

"  I  cannot  refer  to  your  pamphlet,  as  it  is  among  my  books  at 
Cheltenham.    If  you  ha\e  one  to  spare,  pray  send  it  to  Harwood's, 

^  "  Or  Avas  it  secondary  that  you  called  them  ?  I  cannot  at  this  moment 
refer  to  your  letter." 

-  "The  College,  in  their  Report,  have  expressed  themselves  very  well  on 
this  subject." 


236  EDWARD  JENNER. 

the  bookseller,  in  Russel  Street,  who  will  soon  send  me  some 
books  from  town. 

"  Do  you  not  intend  mentioning  cases  of  Small  Pox  after  sup- 
posed security  from  Small  Pox  inoculation  ?  Such  cases  are 
innumerable.  I  think  there  are  thirteen  on  record  among  the 
families  of  the  nobility.  Blair,  I  believe,  has  collected  the  greatest 
number  of  them.  You  know  my  old  opinion  on  the  matter ;  that 
they  occur,  for  the  most  part,  through  the  interference  of  herpetic 
affections  at  the  time  of  inoculation.  One  decisive  proof  you  will 
find  in  Willan's  vaccine  book,  given  by  me.  From  facts  I  go  to 
hypothesis  ;  and  conceive  that  the  appearance  of  the  Small  Pox 
twice  on  the  same  individual  arises  from  the  same  cause.  On  this 
subject  I  could  write  a  long  chapter ;  but  as  it  would  necessarily 
be  theoretical,  you  would  not  thank  me  for  it.  I  must  just  touch 
upon  it.  We  see  that  variolous  matter  may  be  generated  by 
inoculation  on  the  arms  of  one  person  in  that  degree  of  perfection, 
as  to  communicate  the  Small  Pox  by  transferring  it  to  those  of 
another ;  yet  the  person,  whose  constitution  shall  in  the  first 
instance  have  been  exposed  to  it,  shall  remain  unprotected  from 
future  infection,  although  the  system  has  been  deranged  during 
its  presence  on  the  skin.  Where,  then,  is  the  difference,  whether 
the  morbid  poison  was  confined,  or  limited  to  a  point  or  two,  or 
spread  universally  in  the  form  of  pustules  ?  If  the  change  re- 
quired to  give  security  could  not  take  place  in  this  one  instance, 
why  should  it  in  another,  under  the  same  existing  circumstances  ? 
The  peculiarity  of  the  action  [I  do  not  like  to  call  it  morbid, 
because  it  is  generally  salutary],  is  often  too  strong  to  be  over- 
come, yet  1  am  ready  to  conclude  that  this  is  not  a  frequent 
occurrence.   ... 

"What  is  your  Establishment  about  ?  I  fear  little  or  nothing; 
but  you  will  soon  hear  that  a  spirit  of  activity  has  shown  itself 
in  this  county,  which  will  do  more  to  serve  the  cause  of  vaccina- 
tion than  anything  which  has  yet  started  up.  Its  advantages  will 
be  so  self-evident,  that  it  will  soon  run  the  kingdom  over.  You 
shall  know  the  full  particulars  as  soon  as  they  come  out.  The 
great  feature  of  the  scheme  is  this,  to  place  every  man  in  a 
questionable  point  of  view  who  presumes  to  inoculate  for  the 
Small   Pox,  with  such   a  mass  of  evidence  as  will  be  held  up  to 


LIFE  AND   LETTERS.  237 

him  in  fa\our  of  vaccination.  A  general  association  will  be 
formed  of  all  the  medical  men,  in  the  county,  favourable  to  the 
plan  ;  and  I  really  think,  to  avoid  the  ignomin}'  of  resistance, 
nearly  the  whole  will  come  in.  Some  of  the  variolo-vaccinists 
have  already  abjured  their  old  bad  habits  and  joined  the  standard 
before  it  was  half  hoisted.  ,  .  . 

"  You  don't  like  my  style  when  I  write  for  the  public  e^'e,  nor 
do  I  ;  but  I  cannot  mend  it,  for  I  write  then  under  the  impression 
of  fear ;  and  it  must  be  remembered,  that  when  I  write  in  London 
my  brain  seems  full  of  the  smoke.  My  great  aim  is  to  be  per- 
spicuous, and  I  got  credit  for  succeeding  in  the  papers  first  sent 
out ;  but  some  of  the  others  might  be  more  obscure  through  my 
taking  greater  pains  with  them  :  an  error  I  shall  be  happy  to 
avoid  in  future;  for  you  know  I  am  not  fond  of  much  work." 

In  1 8 10.  Jenner  was  afflicted  with  domestic  trials.  He 
lost  one  of  his  sons  from  phthisis,  and  the  occurrence 
aftected  him  so  deeply  that  he  became  melancholic.  His 
symptoms,  says  Baron,  became  so  distressing,  that  active 
means  were  necessary  to  obviate  them.  He  was  sent 
to  Bath,  and  returned  with  health  and  spirits  restored. 
On  his  return  he  was  called  upon  to  attend  the  Earl 
of  Berkeley  up  to  the  time  of  his  death,  and  shortly 
afterwards  Jenner  lost  his  sister. 

In  the  year  181 1,  Jenner  was  destined  to  experience 
''  the  most  unpleasant  event  that  had  befallen  him  in  his 
vaccine  practice."  There  had  been  numerous  reports 
of  Small  Pox  occurring  after  Cow  Pox,  but  they  were, 
for  the  most  part,  silenced  by  the  usual  apologetics,  and 
had  therefore  failed  to  produce  a  lasting  impression.  ^ 


'  Brown,  A71   inquiry   into  tJic  ajitivariolous  powet'  of  J^accinafion , 
Pp.  14,  151,  et  seq.     1809. 


2:58  EDWARD  yENNER. 


But  It  was  very  different  with  the  case  now  to  be 
described.  Jenner  had  been  summoned  to  London 
in  the  first  week  in  June ;  for  on  the  26th  of  May, 
the  Hon.  Robert  Grosvenor  was  seized  with  a;  violent 
attack  of  Small  Pox.  In  four  days,  he  became 
delirious,  and  an  eruption  appeared  on  the  face ;  but 
the  Small  Pox  was  not  expected,  because  he  had 
been  vaccinated  by  Jenner  only  ten  years  previously. 
The  following  day,  the  eruption  "  increased  prodigiously, 
and  some  of  the  worst  symptoms  of  a  malignant  and 
confluent  Small  Pox  showed  themselves."  Master 
Grosvenor  was  attended  by  Sir  Henry  Halford  and 
Sir  Walter  Farquhar,  and  was  also  visited  by  Jenner 
in  company  with  the  latter.  The  boy  recovered, 
although,  from  the  severity  of  the  attack,  a  tatal 
termination  had  been  regarded  as  inevitable. 

A  report  of  the  case  appeared,  in  which  it  was 
stated  that  the  latter  stages  of  the  disease  were  passed 
through  more  rapidly  in  this  case  than  usual,  and  that 
it  was  a  question  whether  this  extraordinary  circum- 
stance, as  well  as  the  ultimate  recovery  ,  of  Master 
Grosvenor,  were  not  influenced  by  previous  vaccination, 
—an  explanation  which  later  gave  rise  to  the  theory 
of  Small  Pox  being  modified,  if  not  prevented,  by 
previous  vaccination. 

P)ut  this  was  not  all.  There  were  several  other  cases 
of  the  same  description,  and  these  events  created  so 
much    excitement   that   the   National   Vaccine   Establish- 


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LIFE  AND  LETTERS.  239 


ment  was  obliged  to  publish  \x  special  report  to  explain 

them    away.       The    state    of    feeling    in     London    may 

be    gathered   from    the   following   letter  from    Jenner  to 

Moore, 

"CocKSTLR  Street,  Charino  Cross, 
"  June  wtli,  181 1. 
"  My  Dear  Friend, — I  should  be  obliged  to  you  to  send  me, 
b}'  the  first  coach,  some  of  the  Reports  of  our  association. 
It  will  probably  be  my  unhappy  lot  to  be  detained  in  this 
horrible  place  some  days  longer.  It  has  unfortunately  happened 
that  a  failure  of  vaccination  has  appeared  in  the  family  of  a 
nobleman  here  ;  and,  more  unfortunately  still,  in  a  child  vaccinated 
by  me.  The  noise  and  confusion  this  case  has  created  is  not 
to  be  described.  The  vaccine  lancet  is  sheathed  ;  and  the  long 
concealed  variolous  blade  ordered  to  come  forth.  Charminsr  ! 
This  will  soon  cure  the  mania.  The  town  is  a  fool, — an  idiot ; 
and  will  continue  in  this  red-hot, — hissing-hot  state  about  this 
affair,  till  something  else  starts  up  to  draw  aside  its  attention, 
I  am  determined  to  lock  up  my  brains,  and  think  no  more  pro 
bono  publico ;  and  1  advise  3'ou,  my  friend,  to  do  the  same  ;  for 
we  are  sure  to  get  nothing  but  abuse  for  it.  It  is  my  intention 
to  collect  all  the  cases  I  can  of  Small  Pox,  after  supposed  security 
from  that  disease.  In  this  undertaking  I  hope  to  derive  much 
assistance  from'  you.  The  best  plan  will  be  to  push  out  some 
of  them  as  soon  as  possible.  This  would  not  be  necessary  on 
account  of  the  present  case,  but  it  would  prove  the  best  shield 
to  protect   us  from   the  past,  and   those  which  are  to  come. 

"  Ever  yours, 

"  Edward  Jewer." 

There  was  a  panic  among  those  \vh(j  had  had  their 
children  vaccinated,  and  many  resorted  at  once  to 
variolous  inoculation.  Jenner's  friends  applied  to  him 
for  advice  in  the  matter.  The  following  is  an  example 
of  the   reply   which   was   received  : — 


240  EDWARD  JENA^ER. 


To  Miss  Calcraft. 

"Take  a  comprehensive  view  of  vaccination,  and  then  ask 
yourself  what  is  the  case  ?  You  will  find  it  a  speck,  a  mere 
microscopic  speck  on  the  page  which  contains  the  history  of  the 
vaccine  discovery.  In  the  very  first  thing  I  wrote  upon  the 
subject,  and  many  times  since,  I  have  said  the  occurrence  of  such 
an  event  should  excite  no  surprise  ;  because  the  Cow  Pox 
must  possess  preternatural  powers,  if  it  would  give  uniform 
security  to  the  constitution,  when  it  is  well  known  the  .Small 
Pox  cannot ;  for  we  have  more  than  one  thousand  cases  to 
prove  the  contrary,  and  fortunately  seventeen  of  them  in  the 
families  of  the  nobility.  We  cannot  alter  the  laws  of  nature  ; 
they  are  immutable.  But,  indeed,  I  have  often  said  it  was 
wonderful  that  I  should  have  gone  on  for  such  a  series  of  years 
vaccinating  so  many  thousands,  many  under  very  unfavourable 
circumstances,  without  meeting  with  any  interruption  to  my 
success  before.  And  now  this  single  solitary  instance  has 
occurred,  all  my  past  labours  are  forgotten,  and  I  am  held  up 
by  many,  perhaps  the  majority  of  the  higher  classes,  as  an  object 
of  derision  and  contempt.  There  is  that  short-sightedness 
among  them  (I  will  not  use  a  harsher  term)  which  makes  them 
identify  a  single  failure  with  the  general  failure  of  the  vaccine 
system.  Before  their  dim  eyes,  stand  two  cases  in  the  family 
of  Lord  Grosvenor,  which  they  cannot  see,  or  will  not.  There 
are  two  children  vaccinated  ten  years  ago,  who  have  been 
constantly  exposed  to  the  infection  of  the  other  child,  and 
inoculated  for  the  Small  Pox  also ;  but  all  without  effect.  The 
infected  child  would  have  died, — that  is  universally  allowed,  — 
but  for  the  previous  vaccination.  There  was  but  little  secondary 
fever ;  the  pustules  were  much  sooner  in  going  off  than  in 
ordinary  cases  ;  and,  indeed,  the  whole  progress  of  the  disease 
was  different.  It  was  modified,  mitigated,  and  the  boy  was 
saved.  What  if  ten,  fifty,  or  a  hundred  such  events  should 
occur?  they  will  be  balanced  an  hundred  times  over  by  those 
of  a  similar  kind  after  Small  Pox.  That  is  what  I  want  to 
impress  on  the  public  mind  ;  but  there  will  be  great  difficulty 
in    bringing    this    about    because    the    multitude    decide    without 


LIFE  AND  LETTERS.  241 


thinking.  No  less  than  three  cases  of  this  description  have 
happened  in  the  family  of  one  nobleman  (Lord  Rous).  But 
I  must  check  myself,  lest  I  should  tire  you  by  going  too  far 
into  the  subject.  I  should  not  have  said  so  much,  had  it  not 
appeared  to  me  that  even  your  judgment  was  carried  down  the 
tide  of  popular  clamour.  1  beg  my  compliments  to  Mrs. 
St.  Quintin.  I  daresay  her  children  are  very  secure  ;  but,  if 
she  has  the  weight  of  a  feather  on  her  mind,  the  safest  and 
best  test  is  vaccination  with  matter  taken  in  its  limpid  state.  I 
have  stated  m}'  reasons  for  this  over  and  over,  in  print  and 
out  of  print. 
'^  Jicne  ic^thy 

The  Grosvenor  case,  and  a  summons  to  Qfive  evidence 
before  the  House  of  Lords  on  the  Berkeley  peerage, 
thoroughly  unnerv-ed  Jenner. 

"  I  can  compare  my  feelings  to  those  of  no  one  but  Cowper 
the  poet,  when  his  intellect  at  last  gave  way  to  his  fears  about 
the  execution  of  his  office  in  the  House  of  Lords.  It  was 
reading  Cowper's  Life,  I  believe,  that  saved  my  own  senses, 
by  putting  me  fully  in  view  of  my  danger.  For  many  weeks 
before  the  meeting,  I  began  to  be  agitated,  and,  as  it  approached^ 
I  was  actually  deprived  both  of  appetite  and  sleep,  and  when 
the  day  came  I  was  obliged  to  deaden  my  sensibility,  and  gain 
courage  by  brandy  and  opium.  The  meeting  was  at  length 
interrupted  by  a  dissolution  of  Parliament,  which  sent  the 
leading  people  to  the  country  ;  and  what  was  at  first  merely 
postponed  was  ultimately  abandoned,  to  ni}^  no  small  delight 
and   satisfaction." 

The  Special    Report   of  the   National   Vaccine    Esta 

blishment,  and  the  succeeding  Reports  of  that  Institution, 

which   contained    many    striking   accounts    (supplied    by 

Jenner)    of  the    alleged    extirpation    of  Small    Pox    by 
VOL.   I.  16 


242  EDWARD  JENNER. 


vaccination  in  the  Caraccas  and  in  Spanish  America, 
and  of  the  results  in  foreign  countries  generally, 
were  greatly  instrumental  in  gradually  restoring  the 
shattered   credit  of  the   new   inoculation. 

Jenner  not  only  continued  to  supply  information  for 
the  press,  but  while  declining  to  enter  into  controversy 
with  the  anti-vaccinists,  he  encouraged  the  use  of  the 
newspapers  as  a  channel  for  "  cheering  and  persuasive 
reports." 

"  I  have  always  thought  that  the  subject  of  vaccination  should  be 
kept  before  the  eyes  of  the  public  by  means  of  the  newspapers. 
This  was  never  well  done,  and  now  it  is  scarcely  done  at  all.  Can 
you  stimulate  the  Board  to  think  of  this  ?  It  would  be  very  easy 
to  give  extracts  from  reports. 

"  I  have  very  lately  received  from  Italy,  a  Poem  '  II  Trionfo 
della  Vaccinia,'  by  Gioachino  Ponta,  who,  I  hope,  is  a  bard  of 
celebrity,  for  he  has  spun  it  out  to  between  4,000  and  5,000  lines. 
It  is  beautifully  printed,  at  the  famous  press  of  Bodoni  at  Parma. 

"  Knowing  nothing  of  the  language  in  which  it  is  written,  it  lies 
before  me  in  a  tantalising  shape.  I  shall  bring  it  to  town.  If  it 
is  a  good  thing,  cannot  we  transform  it  into  English  ? 

"  I  shall  say  something  on  the  Report  in  my  next.  That  part  of 
it  which  points  out  the  happy  results  of  vaccination  among  our 
troops  must  make  the  country  feel,  if  they  have  any  feeling  in 
them.  I  am  hurt  to  think  the  Small  Pox  again  rages.  That  must 
be  the  case,  till  inoculation  is  conducted  in  a  different  way,  if  con- 
ducted at  all.  It  does  not  appear  in  vaccinating  districts ;  for 
example,  in  this.  As  no  particular  notice  has  been  taken  of  the 
foreign  communications,  I  am  thinking  of  sending  them  to  one  of 
the  periodical  journals.  The  Edinburgh  Quarterly  Journal  is  the 
most  respectable. 

"You  do  not  seem  to  have  understood  me  clearly  respecting 
neivspapers.  It  would  certainly  be  infra  dig.  to  go  into  contro- 
versy ;  but  not  so  to  lay  cheering  and  persuasive  reports  before 


LIFE  AND  LETTERS. 


243 


the  public  through  this  widely  flowing  channel.  This  is  what  I 
meant,  and  I  hope  you  will  agree  with  me  in  the  propriety  of  the 
measure. 

"  Make  my  affectionate  regards  to  Mrs.   Moore,  and  believe  me 

"Truly  yours, 

"  Edward  Jenner." 

"  Mrs.  Moore  saw  my  copy  of  the  poem,  and  I  do  not  think 
liked  it  much.  Perhaps  she  might  think  the  thread  spun  a  little 
too  fine.  The  poet's  fancy  has  certainly  flown  in  all  manner  of 
directions,  and  if  you  would  like  to  judge  for  yourself,  my  daughter 
bids  me  tell  you  she  will  with  pleasure  copy  for  you  a  faithful 
analysis  presented  to  me  by  a  lady  here,  a  complete  mistress  of 
the  Italian  language.  I  do  not  mean  the  whole  poem,  but  its 
outline.  The  fact,  as  you  have  an  excellent  knack  at  managing 
these  things,  would  perhaps  find  admittance  with  some  advantage 
in  the  work  you  are  now  engaged  in,  as  a  rub  to  the  British 
Bards,  not  one  of  whom,  whose  voice  has  obtained  celebrity,  has 
sung  one  single  note  in  honour  of  Vaccina.  Anstey,  perhaps, 
may  be  considered  as  an  exception,  who  piped  up  a  Latin  Ode 
about  a  dozen  years  ago,  w^hich  the  indefatigable  John  Ring 
translated  neatly  into  English  verse." 

Jenner  continued  to  assist  Moore  not  only  with 
his  National  Vaccine  Establishment  Reports,  but  also 
with  his  History  of  Vaccination,  and  he  w^as  particu- 
larly anxious  to  influence  Moore  to  utterly  discredit 
Dr.    Pearson's  labours.      Thus  he  wrote  to   Moore  : — 

"  I  should  much  like  to  see  your  paper  containing  the  History 
of  Vaccination,  and  the  exploits  of  the  man  who  brought  it  up. 
In  looking  over  my  papers,  I  have  found  a  great  many  w'hich  will 
throw  a  strong  light  on  the  conduct  of  Dr.  P.  Is  there  any 
chasm  in  this  part  of  your  history  ?  It  is  a  very  important  part, 
and  justice  demands  the  exercise  of  severity.  It  must  begin  with 
the  Petvvorth  business.     This  is  given  by  Lord  Egremont.     Next 


244  EDWARD  JENNER. 


his  uniting  with  Woodville,  and  forming  (without  mentioning  the 
matter  to  me)  his  institution.  His  cajoHng  the  Duke  of  York 
to  be  patron.  The  Duke's  disgracing  him.  His  spreading  the 
Small  Pox  through  the  land  and  calling  it  the  Cow  Pox,  explain- 
ing vicchanically  the  reason  why  it  had  changed  its  character. 
His  treatment  of  me  before  the  Committee  of  the  House  of 
Commons,  attempting  to  prove  that  there  were  papers  found  in 
an  old  chest  at  Windsor,  which  anticipated  my  discovery.  The 
portrait  of  the  farmer  from  the  Isle  of  Purbeck,  with  the  farmer's 
claim  to  reward,  as  the  discoverer  at  the  foot  of  it,  with  a  thou- 
sand minor  tricks  ;  and  finally,  finding  all  tricking  useless,  his 
insinuations  that  vaccination  is  good  for  nothing.  'The  Anti-Vacks 
are  assailing  me,  I  see,  with  all  the  force  they  can  muster  in  the 
newspapers.  The  Morning  Chronicle  now  admits  long  letters. 
Birch  has  certainly  much  the  worst  of  it  there.  Can  you  tell  me 
■who  my  friend  and  defender  is  in  the  Sun,  who  signs  himself 
Conscience  ?" 

It  is  evident  from  a  paragraph  in  the  same  letter 
that  the  ardour  of  his  friend  Ring  had  somewhat 
diminished. 

"  Do  you  ever  see  anything  of  your  neighbour  John  Ring'i  He 
writes  but  seldom  to  me  now,  and  when  he  does  write,  it  is  not  in 
his  old  pleasant  strain.  Nothing  is  going  wrong  with  him  I  hope. 
I  wish  you  would  find  out ;  for,  with  all  his  peculiarities,  he  is  an 
honest  fellow,  and  I  have  a  great  regard  for  him.  He  has  been 
paying  money  for  me  to  some  of  the  institutions,  and  the  enclosed 
draught,  if  you  would  have  the  goodness  to  take  it  to  him,  w^ould 
be  an  excuse  for  your  calling  on  him." 

In     some  later     correspondence     w^ith     Moore,     we 

again     find  Jenner     cutting      the     ground     from     his 

critics    and  dwelHng    on    explanations    of    Cow     Pox 
failures. 


I 


LIFE  AND  LETTERS. 


245 


"  My  Dkar  Moore, — Before  you  make  a  comparative  cal- 
culation of  failures  between  the  vaccine  and  variolous  inocula- 
tions, you  must  consider  the  immense  disparity'  between  the 
numbers  inoculated  with  the  one  and  the  other.  If  you  calculate 
on  a  period  of  forty  years,  I  should  conceive  that  in  the  course  of 
the  last  twenty  years  there  have  been  at  least  five  times  as  many 
vaccinated  as  have  been  variolated.   .  .   . 

"Then  you  must  take  into  account  the  failures  attributable  to 
ignorance,  neglect,  etc.,  etc.,  etc.  Why  is  not  the  list  of  failures 
from  Small  Pox  brought  forth  ?  My  friend,  John  Ring,  had  this 
in  progress  some  years  ago  ;  but  nothing  appears  in  a  compact 
form  from  an}^  quarter.  No  less  than  seventeen  of  such  cases 
have  been  found  in  the  families  of  the  nobility.  The  late  Mr. 
Bromfield,  whom  you  must  recollect  was  surgeon  to  the  Queen, 
abandoned  the  practice  of  inoculation  in  consequence  of  his 
failures,  one  of  which  was  at  the  palace,  from  an  inoculation 
with  a  portion  of  the  same  thread  as  was  used  on  the  arms  of 
the  Duke  of  Clarence  and  Prince  Ernest,  the  Queen's  brother.  Is 
not  this  a  precious  anecdote  for  your  new  work  ?  " 

In  1814,  Jenner  was  received  by  the  Grand  Duchess 
of  Oldenburg,  w^ho  presented  him  to  the  Emperor  of 
Russia,  on  -the  occasion  of  their  visit  to   London. 

He  explained  to  these  royal  personages  his  theory 
of  the  origin  of  phthisis  from  hydatids,  and  also 
pointed  out  to  the  Emperor  that  in  whatever  country 
vaccination  was  conducted  in  a  way  similar  to  that 
which  his  Majesty  had  commanded,  in  the  Russian 
Empire,^    Small    Pox    must    necessarily   become   extinct. 

'  Jenner  had  a  theory  that  both  scirrhus  and  tubercle  originated  in  a 
hydatid.  "  I  long  since  discovered  that  the  ordinary  source  of  scirrhus  is 
the  hydatid,  when  passed  on  to  its  secondary  stage."  In  another  letter 
he  repeats  the  same  of  tubercle.  "What  dreadful  strides  pulmonary 
consumption  seems  to  be  making  over  every  part  of  our  island.     I  trust 


246  EDWARD  JENNER. 

Jenner  also  had  an  interview  with  Count  Platov,  who 
remarked,  "  Sir,  you  have  extinguished  the  most 
pestilential  disorder  that  ever  appeared  on  the  banks 
of  the  Don."  After  this  interview,  Jenner  returned 
to  Cheltenham,  where  he  had  the  misfortune  to  lose 
his  wife,  and  a  short  time  after  this  event  he  removed 
to  Berkeley,  where  he  continued  to  reside  "  in  elegant 
retirement." 

some  advantage  may,  one  day  or  another,  be  derived  from  my  having 
demonstrably  made  out  that  what  is  tubercle  in  the  lungs  has  been  hydatid." 
At  an  interview  with  the  Duchess  of  Oldenburg,  sister  of  the  Emperor  of 
Russia,  he  again  propounded  this  theory,  but  "  as  we  had  not  yet  dis- 
covered the  means  of  absorption  of  these  bodies  in  which  phthisis 
pulmonalis  originates,  it  therefore  remains  at  present  an  incurable  dis- 
ease." The  story  of  this  interview  is  thus  related  by  Fosbrooke.  "The 
Duchess,  who  had  lost  a  much  valued  friend  bj^  this  malady,  then  took 
her  handkerchief  from  her  pocket  and  dropped  a  tear.  She  resumed  her 
conversation,  and  remarked,  '  Though  3^ou  say  it  knows  no  remedy  at 
present,  yet  think  what  a  great  point  is  gained.'  " 

Dr.  Jenner  presented  the  Emperor  with  a  volume  of  his  works,  and 
"he  (the  Emperor)  observed  how  pleasant  must  be  his  feelings  when  he 
contemplated  what  services  he  had  rendered  to  mankind — '  to  the  world, 
sir  ! '  with  emphasis.  Dr.  Jenner  replied  that  when  he  reflected  upon 
the  benefit  of  which  Providence  had  made  him  the  instrument  nothing 
could  exceed  his  satisfaction.  After  a  short  pause  the  Emperor  said, 
'You  have  received,  sir,  the  thanks,  the  applause,  the  gratitude  of  the 
world.'  Dr.  Jenner  answered,  '  Your  Majesty,  I  have  received  the 
thanks  and  the  applauses  of  the  world.'  But  he  did  not  echo  the  third 
position  from  a  regard  to  truth.  The  Emperor  then  fell  back  a  little,  drew 
himself  up  with  an  altered  countenance,  and  his  face  became  suffused. 
A  pause  ensued  ;  and  Dr.  Jenner  resumed  the  conversation  by  observing 
that  local  gratitude  he  had  experienced  abundantly;  but  (pointing  to  a 
diamond  ring  upon  his  finger)  never  in  a  more  gratifying  form  than  in  the 
token  then  before  his  Majesty's  view,  as  being  presented  by  his  august 
mother,  the  Empress  Maria.  The  Grand  Duchess  had  just  joined,  and 
her  tender  feelings  always  permanent,  said,  '  Ah  !  my  mother  !  '  and  then 
dropped  a  tear.  She  added,  '  I  wish,  Dr.  Jenner,  that  you  would  give 
the  Emperor  an  account  of  your  discovery  respecting  pulmonar}'  consump- 
tion '     Dr.  Jenner  made  the  effort,  but  feeling  a  little  embarrassment,  did 


LIFE  AND  LETTERS. 


247 


In  1818-19.  there  was  a  severe  outbreak  of  Small 
Pox  in  Edinburgh,  and  in  18 19,  a  very  fatal  epidemic 
at  Norwich.  There  was  increased  opposition  to 
vaccination,  which  was  supported  by  many  eminent 
members  of  the  profession.  But  Jenner  only  regarded 
these  cases  as  the  result  of  badly  performed  vacci- 
nation, or  explained  that  some  circumstances  had 
interrupted  the  proper  influence  of  vaccination,  such 
as   the  existence   of  cutaneous   disease. 

"With  regard  to  the  mitigated  disease  which  sometimes  follows 
vaccination,  1  can  positively  say,  and  shall  be  borne  out  in  my 
assertion  b}'  those  who  are  in  future  days  to  follow  me,  that  it  is 
the  offspring  entirely  of  incaution  in  those  who  conduct  the 
vaccine  process.  On  what  does  the  inexplicable  change  which 
guards  the  constitution  from  the  fang  of  the  Small  Pox  depend  ? 
On  nothing  but  a  correct  state  of  the  pustules  on  the  arm  excited 
by  the  insertion  of  the  virus  ;  and  why  are  these  pustules  some- 
times incorrect,  losing  their  characteristic  shape,  and  performing 
their  office  partiall}^  ?  But  having  gone  pretty  far  on  this  subject 
in  my  former  letter,  I  shall  not  trouble  you  with  a  twice-told  tale." 

Others,  unable  to  believe  in  the  occurrence  of  Small 
Pox     after     Cow     Pox,    were     inclined     to    regard    the 

not  do  it  in  so  perfect  a  manner  as  he  could  have  wished.  Upon  this  her 
Imperial  Highness  observed  m  her  usual  good-natured  tone,  '  Dr.  Jenner, 
you  do  not  make  this  so  clear  to  my  brother  as  you  did  to  me  at  our  late 
interview.'  He  replied,  '  Madam,  it  is  my  misfortune  to  be  of  a  nervous 
constitution  ;  and  your  Imperial  Highness  must  not  be  surprised  if  a  feel- 
ing of  this  sort  should  assail  me  at  the  present  moment.'  The  Emperor 
then  exhibited  the  most  amiable  condescension  and  knowledge  of  the 
human  mind.  Taking  Dr.  Jenner  by  the  hand  with  a  good-natured  smile, 
he  held  it  till  the  doctor's  embarrassment  had  disappeared.  Dr.  Jenner 
then  resumed  his  narrative  concerning  h3'datids,  and  made  it  particularly 
clear  to  his  Majesty." 


248  EDWARD  JENNER. 


outbreak  as  one  of  malignant  Chicken  Pox.  But 
this  explanation  had  to  be  abandoned,  and  it  was 
acknowledged  even  by  Baron  as  only  a  way  "  of 
getting  rid  of  the  difficulty  by  giving  the  disorder  a 
new  appellation."  At  last,  Small  Pox  was  imported 
into  Berkeley,  and  Henry  Jenner  was  himself  infected. 
Jenner  wrote  to   Dr.  Worthington  : — 

"  We  have  at  last  imported  the  disease  into  this  place.  Henry 
Jenner,  who,  though  he  has  seen  nearly  half  a  century  fly  over  his 
head,  has  not  yet  begun  to  think,  perched  himself  in  the  midst  of  a 
poor  family  pent  up  in  a  small  cottage.  It  was  the  abode  of 
wretchedness,  had  the  addition  of  pestilence  been  wanting.  He 
was  infected,  of  course  ;  and  his  recovery  is  very  doubtful.  I  am 
told  to-day  that  he  is  very  full  of  an  eruption,  the  appearance  of 
which  stands  midway  between  Small  Pox  and  Chicken  Pox.  This 
has  been  spoken  of  by  some  of  the  Dublin  and  Edinburgh 
authors." 

The  outbreaks  of  Small  Pox  in  various  parts  of 
the  country,  and  the  failures  of  vaccination,  led 
Jenner  to  send  a  circular  letter,  early  in  1821,  to  the 
profession,  endeavouring  to  arouse  attention  to  those 
points  in  vaccination  which  he  considered  essential  to 
afford  protection.  Even  the  most  ardent  supporters  of 
vaccination  would  now  only  claim  that  vaccination 
modified  an  attack  of  Small  Pox  in  future,  but 
Jenner's  original  opinion  remained  unchanged.  No- 
thing would  shake  his  belief  that  persons  vaccinated 
were  for  ever  after  secure  from  the  infection  of 
Small  Pox.  On  the  back  of  an  envelope  dated 
January    14th,    1823,    he    wrote: — 


PLATE    III. 


SMALL    POX    AFTER    PERFECT    VACCINATION    (MONRO). 


■/Jm-ir  -At/,  f  C-m  /",/, 


LIFE  AND  LETTERS. 


249 


"My  opinion  of  vaccination  is  precisely  as  it  was  when  I  first 
promulgated  the  discovery.  It  is  not  in  the  least  strengthened  by 
any  event  that  has  happened,  for  it  could  gain  no  strength  ;  it  is 
not  in  the  least  weakened,  for  if  the  failures  you  speak  of  had  not 
happened,  the  truth  of  my  assertions  respecting  those  coincidences 
which  occasioned  them  would  not  have  been  made  out." 

On  January  23rd,  he  wrote  to  his  friend  Gardner: — 

"  I  have  an  attack  from  a  quarter  I  did  not  expect,  the  Edin- 
burgh Review.  These  people  understand  literature  better  than 
physic  ;  but  it  will  do  incalculable  mischief  1  put  it  down  at 
100,000  deaths,  at  least.  Never  was  I  involved  in  so  many 
perplexities." 

Two  days  afterwards,  he  had  an  attack  of  apoplexy, 
which  proved  fatal  the  following  morning,  January 
26th,    1823. 

Before  I  make  any  further  remarks  upon  the 
history  of  Cow  Pox  inoculation,  especially  the  con- 
tinuance of  the  practice  after  Jenner's  death,  I  will 
devote  a  few  chapters  to  the  discussion  of  Jenner's 
original  paper  and  of  his  published  Inqtury,  together 
with  an  account  of  the  various  diseases  which  have 
been  resorted  to  for  a  supply  of  lymph  for  the 
purposes    of  "  vaccination." 


CHAPTER  VII. 

JENNERS  REJECTED   ''INQUIRY:' 

In  the  autograph  manuscript  of  Jenner's  original 
paper,  we  have  a  record  of  the  evidence  upon  which 
he  was  prepared  to  recommend  inoculation  of  Cow 
Pox,  and  we  are  enabled  to  judge  for  ourselves 
whether  the  Royal  Society  was  justified  in  refusing 
the  communication,' 

This  paper"  bears  the  modest  title,  An  Inquiry  into 
tJie  Natural  History  of  a  Disease  known  in  Gloucester- 
shire by  the  A^ame  of  the  Cow-Pox. 

It  opens  with  the  following  statement  : — 

"  The  deviations  of  Man  from  the  state  in  zvJiicli  he  zvas 
originally  placed  by  Nature  seem  to  have  proved  a  prolific  source 
of  Diseases.  From  the  love  of  Splendor,  from  the  indidgences  of 
Luxury  and  from  his  fondness  for  amusement,  he  has  familiariz'd 
himself  with  a  great  number  of  animals,  zvhich  may  not  originally 
have  been  intended  for  his  associates." 

Jenner  mentions  the  horse  as  an  example,  and  pro- 
ceeds to  describe  a  disease  called  by  farriers  "  the 
Grease." 

'  Presented  in  1796,  or  early  in  1797,  v/t/c  p.  138,  and  vol.  ii.,  p.  20. 
-'  Vide  vol.  ii.,  p.  x  et  seq. 


IFACSJ 


;^^ 


IFACSIMILE  OF   THE  FIRST  FOLIO  OF  THE  MA.-.USCKIPT  OF  JESXEIfS  ORIGINAL  PAPER.] 


c 


# 


REJECTED  MANUSCRIPT.  251 

"  //  is  an  inflantmation  and  swelling  in  the  heel,  from  which 
issues  matter  possessing  properties  of  a  very  peculiar  kind.  It  is 
capable  of  generating  a  disease  in  the  Human  Body  (after  it  has 
undergone  the  modification  which  I  shall  presently  speak  of) 
which  bears  so  strong  a  resemblance  to  the  Small  Pox,  that  I 
think  it  highly  probable  it  may  be  the  so?iree  of  that  disease." 

Then  follows  a  suggestion  of  a  possible  relation 
between  this  disease  and  Cow   Pox. 

"  In  this  Dairy  Country,  a  great  number  of  Cozes  are  kept. 
The  office  of  milking  is  here  performed  indiscriminately  by  both 
Men  and  Maid-servants.  One  of  the  former  having  perhaps 
been  appointed  to  apply  dressings  to  the  heels  of  a  Horse  affected 
ivith  the  Grease,  and  not  paying  due  attention  to  cleanliness, 
incatitiously  bears  his  part  in  milking  the  cows,  ivith  some 
particles  of  the  infectious  matter  adhering  to  his  fingers.  Should 
this  be  the  case  it  commonly  happens  that  a  disease  is  com- 
niunicated  to  the  Cows,  and  from  the  Cows  to  the  Dairymaids, 
zvhich  pretty  rapidly  spreads  until  most  of  the  cattle  and  domestics 
of  the  farm  feel  its  unpleasant  co7isequences." 

Thus  Jenner  accounts  for  the  origin  of  Cow  Pox, 
the  characters  of  which  he  proceeds  to  describe  : — 

"  It  first  appears  on  the  nipples  of  Cozvs  in  the  form  of  distinct 
pus t tiles.  They  are  seldom  white,  but  more  commonly  of  a  palish 
blue,  or  rather  of  a  colour  somcivJiat  approaching  to  livid,  and 
are  generally  surrounded  by  more  or  less  of  an  erysipelatous 
inflammation.  These  pustules,  unless  a  timely  remedy  be  applied, 
are  much  disposed  to  degenerate  into  phagedenic  ulcers,  zuhich 
prove  extremely  troublesome^ 

The  eruption  on  the  hands  of  the  milkers  is  more 
fully  given  : — 

"  Several  inflamed  spots  appear  on  different  parts  of  the  hands 
of  the  domestics  employed  in  milking,  and  sometimes  on  the  zvnsts, 
which  quickly  run  on  to  suppuration,  first  assuming  the  appearance 


252  EDWARD  JENNER. 

of  the  small  vesications  produced  by  a  burn  Most  commonly 
they  appear  on  the  joints  of  the  fingers,  and  at  their  extremities  ; 
bnt  whatever  parts  are  affected,  if  the  situation  will  admit,  these 
superficial  suppurations  put  on  a  circular  form,  with  their  edges 
rnore  elevated  than  their  centre,  and  of  a  colour  distantly  ap- 
proacJdng  to  blue.  Absorption  takes  place,  and  tumours  appear 
in  each  axilla.  The  system  becomes  affected — the  pulse  is  much 
quickened,  and  shiverings  zvith  general  lassitude  and  pains  about 
the  loins  and  limbs  ivitJi  vomiting,  come  on.  The  head  is  painful, 
and  the  patient  is  nozv  and  then  even  affected  zuith  delirium. 
These  symptoms,  varying  in  their  degrees  of  violence  (for  they 
rarely  attack  so  severely),  generally  continue  from  one  day  to 
three  or  four,  leainng  idcerated  sores  about  the  hands  xvhich 
from  the  sensibility  of  the  parts,  are  very  troublesome,  and 
frequently  becoming  phagedenic,  like  those  from  whence  they 
sprung,  commonly  heal  sloivly.  The  lips,  nostrils,  eyelids,  and 
other  parts  of  the  body,  are  sometimes  affected  with  sores ;  but 
these  arise  from  their  being  heedlessly  rubbed  or  scratched  ivith 
the  patient's  infectious  fingers.  No  eruptions  on  tlie  skin  have 
followed  the  decline  of  the  feverish  symptoms  in  any  instance 
that  has  come  luider  my  inspection,  one  only  excepted,  and  in  this 
a  very  fezv  appeared  on  the  arms.  They  ivere  of  a  vivid  red  colour, 
very  minute,  and  soon  died  aivay  witJiout  advancing  to  maturq,- 
tion  ;  so  that  I  cannot  determine  zvhether  they  had  any  connec- 
tion with  the  preceding  symptoms,  but  am  inclined  to  think  they 
had  not." 

We  should  naturally  expect  to  hear  some  details 
of  the  history  of  these  observations,  and  still  more  to 
be  told  that  the  country  folk  believed  that  the  disease 
would  prevent  the  Small  Pox,  but  Jenner  introduces 
the  alleged  prophylaxis  thus  : — 

"  Morbid  matter  of  various  kinds,  ivJien  absorbed  into  the 
system,  may  produce  effects  in  some  degree  similar ;  but  what 
renders  the   Coiu  Pox  virus  so   extremely  singular,  is,  that  the 


REJECTED  MANUSCRIPT. 


253 


person  ivlio  has  been  tints  affected  is  for  ever  after  secure  from 
the  infection  of  the  Small  Pox  ;  neither  exposure  to  the  variolous 
effluvia  nor  the  insertion  of  the  matter  into  the  skin  producino- 
this  distemper. 

"  /;/  support  of  this  assertion,  I  shall  produce  many  instances. 
I  could  produce  a  great  number  more,  but  the  follozving,  I 
presume,  zuill  be  fully  sufficient  to  establish  the  fact  to  the  satis- 
faction of  this  very  learned  body." 

We  may  get  a  better  idea  of  the  history  of 
these  instances,  if  we  arrange  them  according  to  the 
years  in  which  the  patients  presented  themselves  to 
be  inoculated  with  Small  Pox.  It  is  impossible  to 
give  the  exact  sequence  of  all,  as  in  some  cases  the 
dates  are  not  eiven. 


TEN  COW  POX  CASES. 

Date  of  Inocidation 
wit/i  Stii  aU  Pox. 

Name. 

Ascertained  to  have 
had  Cow  Pox. 

I. 

1778      . 

.     Mrs.  H 

.     When  very  young. 

2. 

1791      • 

.     Mar}-  Barge 

.     3 1  years  previously. 

3- 

1792      . 

.     Sarah  Portlock    . 

•     2-j      „ 

4- 

5- 

I  '""^-^  ; 

.  \  Joseph  Merret     . 
.  I  William  Smith    . 

•  25      ,, 

•  I.  5,  15  >. 

6. 

;...  : 

.  [  Elizabeth  Wynne 
.  ]  Sarah  Wynne 
.  (  William  Rodvvay 

10  months      ,, 

•     9         .. 
.     38  years 

9- 

After  1782     . 

.     Simon  Nichols 

Some  years  previous!}-. 

0. 

Not  stated 

.     John  Phillips 

.     53  years 

We  learn  from  other  sources  that  Jenner  was  busily 
employed  in  1778,  in  inoculating  Small  Pox  by  the 
method  of  Sutton  ;  but  when  he  wrote  his  paper, 
he  mentions  only  one  case,  that  of  Mrs,  H..  in 
whom,  in  that  year,  the  failure  of  inoculation  was 
attributed  to  a  previous  attack  of  Cow  Pox.  It 
ajjpears,  further,  from   the  dates  given,    that   it   was    not 


254  EDWARD  JENNER. 


until  1 79 1,  that  Jenner  seriously  turned  his  attention 
to  collecting  the  histories  of  similar  cases. 

During  twenty  years  of  country  practice,  Jenner  had 
been  called  upon  to  inoculate  with  Small  Pox,  a  number 
of  persons  who  had  had  Cow  Pox.  For  the  purposes 
of  his  paper,  ten  instances  were  selected  in  which  the 
Small  Pox  inoculation  produced  its  minimum  effect.  In 
these  cases,  Cow  Pox  had  been  contracted  at  times 
varying  from  nine  months  to  fifty-three  years  previously. 
No  cases  of  really  successful  inoculation  after  Cow  Pox 
were  included,  and  no  allowance  was  made  for  individual 
insusceptibility  to   Small   Pox. 

In  addition,  Jenner  adds  three  cases  of  persons  who 
had  been  infected  with  "  grease."  In  one  case  only,  the 
inoculation  produced  its  minimum  effect  ;  in  a  second, 
eruptions  followed;  and  the  third  caught  Small  Pox 
in    the   natural    way. 

THREE  HORSE  GREASE  CASES. 

Date  of  Inoculation  ^  Ascertained  to  have 

'ivith  Small  Fox.  '  '  had  "Grease." 

1.  Not  Stated     .         .     Thomas  Pearce  .         .     6  years  previously. 

2.  ,,  .         .     James  Cole        [.         .         .     Some  years    ,, 

Date  of  Infection  ^  Ascertained  to  have 

with  Small  Pox.  '  had  "Grase." 

3.  Not  stated     .         .     Abraham  Riddiford    .         .     20  years  previously. 

This  presented  a  difficulty.  Jenner  believed  that 
Cow  Pox  arose  from  "  grease,"  and  that  it  protected 
against  .Small  Pox,  yet  persons  directly  infected  with 
"grease"  enjoyed  no  such  immunity.  Jenner  is 
ready  with  an  explanation.  These  cases,  in  his 
opinion,    decisively    proved   that    the  gre^ise    could    not 


REJECTED  MANUSCRIPT.  255 

be    relied    upon    luitil     if     had     been    passed     through 
the  cow. 

Another  difficulty  for  which  no  explanation  was 
forthcoming,  was  encountered  in  the  case  of  William 
Smith,  who  had  Cow  Pox  in  1780.  in  1791,  and  again 
in  1 794  ;  the  disease  being  as  severe  the  second,  and 
third  time,  as  it  was  in  the  first.  Jenner  simply  states 
the  case  without  attempting  to  explain   it. 

"  Although  the  Cozo  Pox  shields  the  constitution  from  the 
Small  Pox,  and  the  Small  Pox  proves  a  protection  against  its 
own  future  poison,  yet  it  appears  that  the  hnman  body  is 
again  and  again  susceptible  of  the  infectious  matter  of  the 
Coiu  Pox." 

Jenner,  we  must  remember,  was  inquiring  into  the 
nahtral  history  of  the  disease,  and  he  was  anxious  to 
observe  more  accurately  the  progress  of  the  infection. 

He  selected  a  healthy  boy  about  eight  years  old, 
with  a  view  to  inoculate  him  with  Cow  Pox.  On 
the  14th  of  May,  1796,  matter  was  taken  from  a 
*'  suppurated  sore  on  the  hand  of  a  dairymaid "  and 
inserted  by  means  of  two  superficial  incisions  in  the 
arm,  each  about  three-quarters  ot  an  inch  long. 

"  On  the  scventJi  day,  he  complained  of  uneasiness  in  the 
axilla,  and  on  the  nintJi,  he  became  a  little  chilly,  lost  his 
appetite,  and  had  a  slight  headache.  During  the  zvhole  of  this 
day,  he  zvas  perceptibly  indisposed,  and  had  rather  a  restless 
flight,  but  on  the  day  following,  he  zuas  peifectly  zuell.  TJie 
appearance  and  progress  of  the  incisions  to  a  state  of 
maturation  were  pretty  much  the  same  as  when  produced  in 
a    similar    manner   by    variolous    matter.      The    only    difference 


256  EDWARD  JENNER. 


which  I  perceived  zvas  that  the  edges  assumed  rather  a  darker 
hue,  and  that  the  efflorescence  spreading  round  the  incisons 
took  on  rather  more  of  an  erysipelatous  look  than  zve  commonly 
perceive  zvhen  variolous  matter  has  been  made  use  of  in  th^ 
same  manner." 

The  next  stage  of  this  experiment  was,  to  apply  the 
variolous  test.  On  the  ist  of  July  (less  than  seven 
weeks  after  the  insertion  of  the  Cow  Pox),  this  boy 
was  inoculated  with  matter  taken  immediately  from 
a  Small   Pox  pustule. 

"  Several  punctures  and  slight  incisions  zverc  made  on 
both  his  arms,  and  the  matter  was  well  rubbed  into  them, 
but  no  disease  folloived.  The  same  appearances  only  ivere 
observable  on  tJic  arm  as  when  a  patient  has  had  variolojis 
matter  applied  after  having  cither  the  Coiv  Pox  or  the 
Small   Poxr 

Jenner  appears  to  have  anticipated  as  an  objection, 
that  the  test  had  been  applied  less  than  seven  weeks 
after  the  original  operation.  The  statement  that  the 
boy  felt  "so  slight  an  affection  of  the  system"  after 
Cow  Pox,  that  he  was  "perfectly  well"  on  the  tenth 
day,  leads  the  reader  to  conclude  that  the  test  was 
not  applied  until  five  or  six  weeks  had  elapsed  after 
recovery}  In  the  accompanying  table  [pp.  258,  259] 
I  have  made  an  analysis  of  the  cases  which  Jenner 
described,  and  we  can  see  what  was  the  material 
which    he    had    collected    for    a    paper    for    the    Royal 

'  l^ide  p.  136. 


REJECTED  MANUSCRIPT.  357 


Society.  Mc  had  put  together  a  few  cases  which 
seemed  to  support  the  tradition  of  the  dairymaids  ;  he 
showed  by  one  experiment  that  the  disease  could  be 
communicated  from  the  cow  to  the  human  subject, 
after  the  manner  of  variolous  inoculation,  and  that  in 
this  case  the  attempt  a  few  weeks  afterwards  to 
inoculate  with  Small  Pox,  had  proved  abortive.  This 
he  considers  to  be  quite   sufficient. 

"■  I  presiiine  it  ivonld  be  szvelling  this  paper  to  an  niinecessary 
bulk,  %vere  I  to  produce  furtJier  testimony  in  support  of  my  asser- 
tion that  the  Cow  Pox  protects  the  human  constitution  from  the 
infection  of  the  Small  Pox.  I  shall  proceed  then  to  offer  a  few 
general  remarks  upon  the  sidfect,  to  some  others  ivJucJi  are  con- 
nected zuith  it.  Though  I  am  myself  perfectly  convinced,  from  a 
great  nujnber  of  instances  ivhich  have  presented  themselves,  that 
the  source  of  the  Coiv  Pox  is  the  morbid  matter  issuing  from 
the  newly  diseased  heels  of  horses,  yet  I  could  have  zuishcd,  had 
circumstances  allozved  me,  to  have  impressed  this  fact  more 
strongly  on  the  minds  of  this  Society  by  experiments." 

Jenner  assumes  that  the  virus  from  the  horse's 
heels  is  intensified  by  being  passed  through  the  cow,  on 
the  ground  that  the  horse  so  rarely  affects  his  dresser 
with  sores,  while  a  milkman  rarely  escapes  infection 
from  the  cow.  He  could  not  positively  determine,  if 
the  disease  from  the  horse  or  cow  could  affect  the 
sound  skin,  but  thought  that  it  probably  did  not. 

"  The  hands  of  the  farm  servants  in  this  neighbour Jiood,  from 
the  nature  of  their  employments,  are  co?istatitly  exposed  to  those 
injuries  ivhich  occasion  abrasions  of  the  cuticle,  to  punctures  from 
thorns  and  such  like  accidents T 

VOL.  I.  17 


Analysis    of    the    Cases 

I-— Ten  Cases  c ;  '■ 


I.  Joseph  Merret 

II.  Sarah  Port  lock 

III.  John  Phillips 

IV.  Mary  Barge 
V.  Mrs.  H 


Occvpatio7i. 


VI,   Sarah  Wynne 


VII,    William  Rodivay 


VIII.  Elizabeth   Wynne 


IX.    William  Smith . 


X.  Simon  Nichols 


Farm -servant  and 
milker 


Farm  servant 
Tradesman  . 


Farm  servant 


Respectable  gentle- 
woman. 


Date  of  Cow  Pox. 


1770  (Several  sores  on  his  hands). 

1765 

At  9  years  of  age 

1760 


'  When  very  young  contracted  by 
contact  with  some  of  the  servants 
of  the  Family  who  were  infected  by 
Cows.  Her  hands  were  extremely 
sore  and  her  Nose  was  inflamed 
and  very  mucli  swoln." 


Dairymaid    .         .  i  May  1796 


Servant  at  a  Dairy  1  Summer  of  1796 


Dairymaid    . 


Farm  servant 


Farm  servant 


I.    Tliomas  Pearce    .'  Farrier 


II.   .\fr.  James -Cole 


Farmer 


III.  .1/;-.     Abraham    1  Farmer 
Riddiford  . 


1759  ("'In  a  very  slight  degree,  one  very- 
small  sore  only,  breaking  out  upon 
the  little  finger  of  her  hand,  and 
scarcely  any  indisposition  following"^ 

1780  ( ' '  One  of  his  hands  had  several 
ulcerated  sores  upon  it,  and  he  be- 
came very  ill"  with  such  symptoms 
as  have  been  before  described.  In 
the  year  1791 . . .  he  became  affected 
with  it  the  second  time,  and  in  the 
year  1794  he  was  so  unfortunate  as 
to  catch  it  again  "). 

1782.  Laterat  another  farm  his  hands 
were  "affected  in  the  common  way, 
and  he  was  much  indisposed." 


No  date.  (Sores  on  his  fingers  which 
suppurated  and  which  occasioned  a 
pretty  severe  indisposition). 

No  date 


No  date.  (Very  painful  sores  in  both 
of  his  hands,  tumours  in  each 
axilla,  and  severe  and  general  in- 
disposition). 


Date  of  Inoaclalion  with  Small  Pq  \ 


April  1795 

1792.     In  both  arms 


At  the  age  of  62,  with  matter  ju 
before  the  commencement  of  ih 
eruptive  Fever,  and  instantly  11 
serted. 


1791 


1778.       "With 
matter." 


March  28th,  1797.  "  By  carofull 
rubbing  variolous  matter  into  tu 
slight  incisions  made  upon  the  I.l 
arm. '' 

Feb.  13th,  1797.  "Variolous  matte 
was  inserted  into  both  his  arms,  ii 
the  right  by  means  of  a  sligli 
incision  and  into  the  left  1) 
punctures." 


March^  28th,    1797. '^  "  By   makin; 

two    superficial    incisions    on    tlii 

left  arm  in  which  the  matter  w.i 

cautiously  rubbed." 
In   the    spring    of    the    year    179; 

Twice. 


Some  years  afterwards. 


II.— Three  Cases  o 

Si-\  years  afterwards  variolous  nintte; 
inserted  into  his  arm  repeatedly. 

Some  years  afterwards  was  inoculate( 
with  variolous  matter. 


[Not  stated. 


1.   A  Boy     . 
(al)out  8  years  okl) 


III.— ^One  Case  ol 

Inoculated   by  Jenncr  on  the  14th  May,   1796,  with   matter  taken   from 


suppurated  sore  on  the  hand  of  a  dairymaid 
ficial  incisions  each  about  J-in.  long, 


by  means  of  two  snpei 


,\ir's    Original    Paper. 


Hial  Cow  Pox. 


Result. 


■  1  efflorescence  only  taking  on  an  erysipelatous 
..)ok  fibout  the  centre,  appearing  on  tlie  skin  near 
ihe  pvnctured  parts." 
w  in  pieccding  case  ....... 


A  stin,  .-like  feel  in  the  part ;  an  efflorescence  appeared 
;\!iich  on  the  4th  day  was  rather  extensive,  and  some 
ileg^ei  of  pain  and  stiffness  were  felt  about  the 
shoulfi  ;r,  but  on  the  5th  day  these  symptoms  began 
10  dis.  ppear,  and  in  a  day  or  two  after  went  entirely 
oft' wit  lout  producing  any  effect  on  the  system." 
All  efti  jrescence  of  a  paUsh-red  colour  soon  appeared 
ibout  the  parts  where  the  matter  was  inserted,  and 
stjread  itself  rather  extensively,  but  died  away  in  a  few 
ilays  without  producing  any  variolous  symptoms." 
he  sai  le  appearance  followed  as  in  the  preceding 
c^ses  ;  an  efllorescence  on  the  arnr  without  any 
•  ffect  (  n  the  constitution. 


'.A  litil  ■  inflammation  appeared  in  the  usual  manner 
.iround  tlie  parts  where  the  matter  was  inserted,  but 
.•>o  eari  >  as  the  5th  day  it  vanished  entirely  without 
produi^ng  any  effect  on  the  system." 
Iloth  w  -re  perceptibly  inflamed  on  the  5rd  day.  After 
this  thi  intiammation  about  the  punctures  soon  died 
.iway,  JUt  a  small  appearance  of  erysipelas  was 
inanife  t  about  the  edges  of  the  incision  till  the  8th 
day,  wl  en  a  little  uneasiness  was  felt  for  the  space  of 
half  ar  hour  in  the  axilla.  The  inflammation  then 
hastily  disappeared  without  producing  tlie  most  dis- 
t:uu  in,  rk  of  affection  of  the  system." 

\  little  efflorescence  soon  appeared,  and  a  tingling 
sen.sati on  was  felt  about  the  parts  until  the  3rd  day, 
when  t  oth  began  to  subside,  and  so  early  as  the  5th 
day  it  w  as  evident  that  no  indisposition  would  follow." 

No  affection  of  the  system  could  be  produced." 


'  U'ith  i.ot  the  least  effect  on  the  constitution." 


casual  Horse  Grease. 

'  W'itliout  being  aljle  to  produce  anything  more  than 
>light  i  iflammation,  which  appeared  very  soon  after 
tlie  matter  was  applied." 

\  Httle  pain  in  the  axilla  and  feet ;  a  slight  indisposi- 
tion for  three  or  four  hours.  A  few  eruptions  showed 
themseives  on  the  forehead,  but  they  very  soon  dis- 
;il)peared  w  ithout  advancing  towards  maturation." 


Exposure  to  Injection  of  Small  Pox. 

• '  During  the  whole  time  that  his 

family  had  the  Small  Pox,  one  of 

whom  had  it  very  full." 
"  Xursed  one  of  her  own  children 

who  had  accidentally  caught  the 

disease." 
[Not  stated.] 


"  Repeatedly  employed  as  a  nurse 
to  Small  Pox  patients." 


Soon  after  infection  with  Cow  Pox, 

"Mrs.  H was  exposed  to  the 

contagion  of  the  Small  Pox,  where 
it  was  scarcely  possible  for  her  to 
have  escaped  it,  as  she  regularly 
attended  a  relative  who  had  the 
disease  in  so  violent  a  degree  that 
it  proved  fatal  to  him." 

[Not  stated.]  .         .         .         . 


Result. 

'  Received  no  injury  from 
exposure  to  the  contagion." 

'  No  indisposition  ensued." 


[Not  stated.] 


[Not  stated.] 


'  .Since  associated  with  those  who 
had  the  Small  Pox  in  its  most 
contagious  state." 


With  several  otlier  patients  inocu- 
lated at  the  same  time  "  he  con- 
tinued during  the  whole  time  of  ; 
their  confinement."  I 


"And  afterwards  exposed  him  to 
the  contagion  of  the  .Small  Pox." 

[Not  stated.]  .... 


"  Was  assured  that  he  never  need  to 
fear  the  infection  of  tlie  Small  Pox. 
I'ut  this  assertion  proved  falla- 
cious ;  for  on  being  exposed  to  the 
infection  upwards  of  twenty  years 
afterwards, 


Without  experiencing  any 
ill  consequence." 


■  No  indisposition  followed." 


'  Without  feeling  any  effect 
from  it." 


•  With  not  the  least  effect 
on  tin;  constitution." 


'  With  as  little  effect." 


"He  caught  the  disease, 
whicli  took  its  regular 
course,  in  a  very  mild  way. 
.  .  .  There  was  no  room  left 
forsuspicionas  tothereality 
of  the  disease  as  I  inoculated 
some  of  his  family  from  the 
pustules  who  liad  the  Small 
Pox  in  conse(iuence." 


Inoculated  Cow  Pox. 

•On  the  tst  of  July  this  boy  was  inoculated  with  matter  immediately  taken  from  a  small-pox  pustule,  several  punctures 
and  incisions  were  made  on  both  his  arms,  and  the  matter  was  well  rubb'd  into  them,  but  no  disease  followed.  The 
same  appearances  only  were  observable  on  the  arms  as  when  a  Patient  has  had  variolous  matter  applied  after  having 
either  the  Cow  Pox  or  the  Small  Pox."' 


26o  EDWARD  JENNER. 


Having  assumed  that  his  theory  of  the  origin  of 
Cow  Pox  was  correct,  he  continues  the  argument  until 
it  ukimatdy  culminates  in  the  theory  of  the  origin, 
ex  animalibns,  of  all  infectious  fevers  and  many  other 
communicable  diseases  of  man. 

''It  is  air  ions  to  observe  that  this  matter  acquires  nezv 
properties  by  passing  from  the  horse  through  another  medium, 
that  of  the  cow  ;  not  only  is  its  activity  hej'eby  increased,  but 
those  specific  properties  become  invariable  ivJiich  induce  in  the 
human  constitution  symptoms  similar  to  those  of  the  variolous 
fever,  and  effect  in  it  that  peculiar  change  zvhich  for  ever  renders 
it  unsusceptible  of  the  variolous  contagion. 

"  May  tve  not  then  reasonably  infer  that  the  source  of  the 
Small  Pox  is  the  matter  generated  in  the  diseased  foot  of  a  horse, 
and  that  accidental  circumstances  may  have  again  and  again 
arisen,  still  ivorking  new  changes  upon  it,  until  it  has  acquired 
the  contagious  and  malignant  form  under  ivhicJi  zve  noiv 
commonly  see  it  making  its  devastations  among  us?  And  from 
a  consideration  of  the  change  which  the  infectious  matter  from 
the  horse  has  ^mdergone  after  it  lias  produced  a  disease  on  the 
cozv,  may  zve  not  conceive  that  many  contagious  ^-'diseases  notv 
prevalent  among  us,  may  ozve  their  present  appearance  not  to  a 
simple,  but  a  compound  origin  ?  For  example,  is  it  hard  to 
imagine  that  the  measles,  the  scarlet  fever,  and  the  ulcerous  sore- 
throat  zvith  a  spotted  skin  have  sprung  from  the  same  source, 
assuming  some  variety  in  their  forms  according  to  the  nature  of 
their  nezv  combinations  ?  The  same  question  zvill  apply  respect- 
ing the  Yazvs  and  the  Syphilis,  and  indeed  many  other  diseases." 

Jenner  adds  that  he  believes  in  varieties  of  Small  Pox, 
and  mentions  that  seven  years  previously  an  outbreak, 
which  the  nurses  and  the  common  people  called  the 
Swine  or  Pig  Pox,  appeared  in  many  towns  and 
villages    in    Gloucestershire ;    a    fatal    case    was    scarcely 


REJECTED  MANUSCRIPT.  261 


heard  of,  and  the  people  had  only  as  mild  and  light 
a  disease,  as  if  they  had  been  inoculated  with  variolous 
matter  in  the  usual  way. 

Jenner  then  proceeds  to  give  a  "  cautionary  hint  " 
with  regard  to  "  management  of  the  variolous  matter 
previously  to  its  being  used  for  the  purpose  of  inocu- 
lation." He  gives  the  instance  of  a  fellow-practitioner 
who  employed  matter  not  unfrequently,  after  it  had 
been  taken  several  days  from  the  pustules.  When 
inoculated  it  produced  inflammation  of  the  incised 
parts,  swelling  of  the  axillary  glands,  and,  as  he  had 
been  informed  by  the  patients,  eruptions.  "  But," 
says  Jenner,  "  what  was  this  disease  ?  Certainly  not 
the    Small    Pox." 

"  The  same  2infortunate  circuDistancc  of  giving  a  disease, 
supposed  to  be  the  Small  Pox,  -cvith  inefficacious  matter,  having 
come  under  the  direction  of  some  other  practitioner,  and  probably 
from  the  same  incautious  method  of  securing  the  variolous 
matter,  I  avail  myself  of  this  opportunity  of  me?itioning  zvhat  I 
conceive  as  of  great  importance  ;  and  as  a  further  cautionary 
hint  I  shall  take  the  liberty  of  adding  another  observation  on 
this  subject  of  inoculation. 

"  Whether  it  be  yet  ascertained  by  experiment  that  the  quantity 
of  variolous  matter  inserted  into  the  skin  makes  any  difference 
1^'itJi  respect  to  the  subsequent  mildness  or  violence  of  the  disease,  I 
know  not ;  but  I  have  the  strongest  reason  for  supposing  that  if 
eit/ier  the  punctures  or  incisiotis  be  made  so  deep  as  to  go  through 
it,  and  wound  the  adipose  covering  beneath,  that  the  risk  of  bring- 
ing on  a  violent  disease  is  greatly  increased.  I  have  knoivn  an 
inoculator  whose  practice  was  to  go  deep  enough,  to  use  his  own 
expression,  to  see  a  bit  of  fat  and  then  to  lodge  tJie  matter.  The 
great  number  of  bad  cases,  and  the  fatality  which  attended  this 


c62  EDWARD  JENNER. 


practice,  tvas  almost  inconceivable,  for  let  it  be  recollected  that  it 
is  only  from  a  different  mode  of  receiving  the  infections  par- 
ticles that  the  difference  betivcen  inoculation  and  the  natural 
Small  Pox  arises.  Though  it  is  very  improbable  that  any  one 
would  inoculate  in  this  luay  by  design,  yet  this  observation  may 
tend  to  place  a  double  guard  over  the  Lancet,  when  infants  fall 
under  the  care  of  the  inoculator,  as  the  skin  is  comparatively  so 
very  thin. 

In  other  words,  any  one  disposed  to  apply  the 
variolous  test  after  Cow  Pox,  was  cautioned  to  employ 
the  Suttonian  method,  and  if  an  eruption  followed,  it 
was  not  to  be  hastily  concluded  that  genuine  Small 
Pox  had  resulted. 

As  to  how  lonof  Cow  Pox  had  been  known  amoncr 
the  farmers,  Jenner  says  that  the  oldest  among  them 
were  acquainted  with  it,  and  had  heard  their  forefathers 
speak  of  it,  but  a  connection  with  Small  Pox  was 
unknown  to  them,'-,'and  his  belief  that  the  disease  arose 
from  the  heels,  of  horses,  was  new  to  most  of  themJ 

"  But  it  has  at  length  produced  conviction,  and  probably  from 
the  precautions,  which  they  noiv  seem  disposed  to  adopt  (for  a 
farmer  is  not  the  most  flexible  of  Jniman  beings),  the  appearance 
of  the  Cozv  Pox  here  may  either  be  extinguished  or  become 
extremely  rare." 

In  conclusion,  Jenner  proposes  to  substitute  Cow  Pox 
inoculation  for"  Small  Pox  inoculation,  and  this  is  the 
answer  which  he  is  prepared  to  give,  should  any  one 
ask   whether    this   "  discovery,"  or    rather  investigation, 

'  Compare  Jenner's  MS.  notes,  p.  376. 


REJECTED  MANCSCRIPT.  26  = 


were    a    matter    of   mere    curiosity    or    tended    to    any 
beneficial  purpose. 

"  /  slunild  anszvcr,  that  notivitJistanding  the  happy  effects  of 
Inoculation,  with  all  the  iviprovements  ivhicJi  the  practice  has 
received  since  its  introduction  into  this  coimtry,  zve  sometimes 
observe  it  to  prove  fatal,  and  from  this  circumstance  tvc  feel  at 
all  times  someiuhat  alarmed  for  its  consequences.  Ihit  as  fatal 
effects  have  never  been  knozvn  to  arise  from  the  Coiu  Pox,  even 
ivhen  expressed  in  the  most  unfavourable  manner,  that  is,  zvhen 
it  has  accidentally  produced  extensive  inflammations  and  suppura- 
tions en  the  hands ;  and  as  it  clearly  appears  that  this  disease 
leaves  the  constitution  in  a  state  of  perfect  security  from  the 
infection  of  Small  Pox,  may  ivc  not  infer  that  a  mode  of  Inocu- 
lation migJit  be  introduced  preferable  to  that  at  present  adopted, 
especially  among  those  families  vohicli,  from  previous  circjimstances, 
lue  may  Judge  to  be  predisposed  to  have  the  disease  unfavourably? 
It  is  an  excess  in  the  number  of  pus  tides  zuhich  we  chiefly  dread 
in  the  Small  Pox ;  but  in  the  Cozv  Pox  no  pustules  appear,  nor 
does  it  seem  possible  for  the  contagious  matter  to  produce  the 
disease  by  effluvia  or  by  any  other  means,  as  I  have  before  observed, 
than  contact ;  so  that  a  single  individual  in  a  family  might  at 
any  time  receive  it  ivithout  the  risk  of  infecting  the  rest,  or  of 
spreading  a  disease  that  fills  a  country  zvith  terror.  Without 
further  research,  I  should  tJiereforc  not  in  the  least  hesitate  to 
inoculate  Adults,  and  Children  not  very  young,  with  the  matter 
of  Cow  Pox  in  preference  to  common  variolous  matter.  Hozv  far  it 
may  be  admissible  on  tender  skins  of  infants  firther  experiments 
must  determine.  I  have  no  other  scruples  than  such  as  arise 
from  the  darkish  appearance  of  the  edges  of  the  incisions  on  the 
arm  of  the  Boy  zvJiom  I  inoculated  zvith  this  matter,  the  only 
experiment  I  had  an  opportunity  of  making  in  that  way.  But  in 
this  case  the  incisions,  though  perfectly  superficial,  zvere  made  to  a 
much  greater  extent  than  zvas  necessary  for  communicating  the 
infection  to  the  system.  Hozvever  it  proved  of  no  consequence,  as 
the  arm  never  became  painful  nor  required  any  application.  I 
shall  endeavour  still  farther  to  prosecute  this  Inquiry,  an  Inquiry 


264  EDWARD  JENNER. 


I  trust  not  merely  speculative,  but  of  sufficient  moment  to  inspire 
the  pleasing  hope  of  its  becoming  essentially  beneficial  to 
Mankindr 

Such  was  the  evidence  on  which  Jenner  had  first 
proposed  to  introduce  vaccination ;  a  proposal  which 
was  rejected,  in  not  very  flattering  terms,  by  the 
Council  of  the   Royal   Society. 

I  was  struck  by  the  substitution,  in  a  different  hand- 
writing, of  the  word  investigation  for  discovery.      Some 
friendly   critic   had    evidently   read   the    manuscript    and 
made    this     correction     among     others.        Had     Jenner 
made  a  discovery,  and,   if  so,   what  was   it?      He  had 
not   discovered  that    Cow    Pox    produced    an    immunity 
from    Small   Pox ;    for,   assuming  such  to    be   the  case, 
it     was    the     discovery    of   the     dairymaids.       He    had 
not    discovered    that    Cow '  Pox    could    be    intentionally 
communicated    from    cow    to    man,    for    this    had     been 
practised  by  Jesty  and  others.      He  was  not    the    first 
to  employ  the    test    of  variolous  inoculation  after  Cow 
Pox,    for    this    had    been    performed  upon    Mrs.   Jesty ; 
and   as   for    the  test  of  exposure  to  infection,    this  had 
been    carried   out    repeatedly.       The    correction    of  his 
critic   was   therefore    fully  justified.      Jenner    had    made 
no    discovery,  but  he  had   carried    out  an  investigation 
from     which     he     was     led     to     observe     a     similarity 
between     inoculated    Cow     Pox    and     inoculated    Small 
Pox,   and  to  express  a  belief  in  the  origin  of  Cow  Pox 
and    Small    Pox,   and    many  other  diseases,   from   horse 


REJECTED  MANUSCRIPT.  265 


grease.  Apart  from  these  speculations,  a  Dorsetshire 
sLirQ^eon  ^  had  done  ahnost  as  much  as  Tenner.  Both 
had  proposed  to  introduce  Cow  Pox  inoculation  as 
a  substitute  for  Small  Pox  inoculation,  for  which  the 
surgeon  was  threatened  with  the  loss  of  his  practice, 
and  Jenner  with  the  loss  of  such  scientific  credit  as 
he  had  hitherto  possessed. 

'  Vide  p.  116. 


CHAPTER  VIII. 

JENNER' S  PUBLISHED  ''  INQUIRY:' 

Jenner  was  by  no  means  discouraged  by  the  verdict  ot 
the  Royal  Society,  and  he  had  no  intention  of  abandon- 
ing his  project.  He  proceeded  to  amphty  his  original 
paper  ^  by  inserting  the  cases  of  William  Stinchcomb  and 
of  the  paupers  of  Totworth,  between  Cases  X.  and  XL, 
and  he  also  added  the  case  of  Sarah  Nelmes,  from 
whom  he  had  taken  matter  to  inoculate  the  boy  Phipps. 
Her  case  was  inserted  between  Cases  XIII.  and  XIV, 
Jenner  also  re-inoculated  Phipps  with  Small  Pox,  but 
"  no  sensible  effect  was  produced  upon  the  constitution." 
Jenner  was  most  anxious  to  see  his  pamphlet  in 
print,  but  he  appears  to  have  resolved,  in  June  1797, 
not  to  risk  a  second  rejection  by  the  Royal  Society. 
Thus  he  wrote  to  a  friend  : — 

"  I  have  shown  a  copy  of  my  intended  paper  on  the  Cow 
Pox  to  our  friend  Worthington,  who  has  been  pleased  to  express 
his  approbation  of  it,  and  to  recommend  my  pubUshing  it  as 
a  pamphlet  instead  of  sending  it  to   the  Royal   Society." 

But  Jenner  wished  to  add  some  more  original 
material  to  the  paper,  and  he  therefore  kept  it  in  hand 

'   Vide  vol.  ii.,  pp.    1-33. 


PUBLISHED   "INnUIRY."  26; 


in  the  hope  that  he  miq-ht  meet  with  some  more  cases 
o\  the  Casual  Cow  Pox  in  the  dairies,  and  that  he 
might  have  time  to  fuhil  his  intention  of  proving,  by 
experiment,  its  origin  from  "  grease."  On  the  2nd 
of  August,   he  wrote  : — 

"  The  simple  experiment  of  appl3ing  the  matter  from  t'-.e 
heel  of  the  horse,  in  its  proper  state,  to  the  nipples  of  the  cows, 
when  they  are  in  a  proper  state  to  be  infected  by  it,  is  not  so 
easil}-  made  as  at  first  sight  may  be  imagined  ;  after  waiting  with 
impatience  for  months  in  my  own  neighbourhood,  without  effect,  I 
sent  a  messenger  to  Bristol,  in  vain,  to  procure  the  true  virus. 
I  even  procured  a  young  horse,  kept  him  constantly  in  the  stable, 
and  fed  him  with  beans  in  order  to  make  his  heels  swell,  but  to 
no  purpose.  By  the  time  the  Pamphlet  goes  to  a  second  edition, 
1    hope   to  be   able   to  give   some   decisive  experiments." 

But  no  Cow  Pox  appeared  in  the  dairies,  and  his 
researches  w^ere  thus  interrupted  until  the  spring  of  1  798, 
when  an  outbreak  occurred  which  afforded  him  the 
much-wished-for  opportunities  for  further  observations. 

A  mare,  the  property  of  a  dairyman  in  a  neigh- 
bouring parish,  began  to  have  "sore-heels"  in  the 
latter  part  of  February  1798.  The  horse's  heels  were 
dressed  by  the  farm  servants,  Thomas  Virgoe,  William 
Wherret,  and  William  Haynes  who,  in  consequence, 
contracted  sores  on  their  hands,  followed  by  inflamed 
lymphatic  glands  in  the  arms  and  axillce  ;  and  con- 
stitutional symptoms,  shiverings  succeeded  by  heat, 
lassitude,  and  pains  in  the  limbs.  Haynes  and  Virgoe 
had  both  previously  been  successfully  inoculated  with 
Small   Pox,  but  Wherret  had  not  had   Small   Pox. 


268  EDWARD  JENNER. 


"  Haynes  was  daily  employed  as  one  of  the  milkers  at  the  farm, 
and  the  disease  began  to  shew  itself  among  the  cows  about 
ten  days  after  he  first  assisted  in  washing  the  mare's  heels.  Their 
nipples  became  sore  in  the  usual  way,  with  bluish  pustules;  but  as 
remedies  were  early  applied  they  did  not  ulcerate  to  any  extent." 

The  Cow  Pox  was  raging  in  several  dairies,  but 
Jenner  confined  his  attention  to  this  one  outbreak. 
Whether  it  was  the  only  one  in  which  there  happened 
to  be  a  horse  with   "greasy"   heels,   we  are  not  told, 

Jenner's  mind  was  occupied  with  the  opportunity  of 
making  a  double  experiment  ;  inoculation  of  one  child 
with  humanised  horse-grease,  and  of  another  child  with 
matter  from   the  cow's   teats. 

With  regard  to  the  horse-grease  inoculation,  Jenner 
says  : — 

"  This  experiment  was  made  to  ascertain  the  progress  and 
subsequent  eifects  of  the  disease  when  thus  propagated." 

The  object  of  this  experiment  is  thus  clearly  stated. 
Jenner  had  already  condemned  horse-grease,  for  he 
had  committed  himself  to  the  statement  that  it  had 
been  decisively  proved  that  grease  could  not  be  relied 
upon  as  a  protective  against  Small  Pox}  The  object 
of  studying  the  progress  and  effects  may  have  been 
a  double  one.  First,  to  ascertain  whether  an  attack 
of  Small  Pox  would  follow.  For  Jenner  was  firmly 
of  opinion  that  the  grease  was  the  source  of  Small 
Pox  ;  it  was  after  it  was  transmitted  through  the 
cow,  that   it  appeared    in   the  modified   form  known  as 

'  Vol.  ii.,  pp.  i8  and  i6o. 


PUBLISHED  "IXQUIRY:'  269 

Cow  Pox.  This  outbreak,  therefore,  afforded  him 
an  opportunity  for  testing  his  theories.  He  could 
inoculate  one  child  with  the  matter  of  the  grease, 
and  another  with  the  matter  of  Cow  Pox,  and  study 
the  results  side  by  side.  And  if  he  could  experi- 
mentally generate  Small  Pox  in  the  one  case,  and 
carry  on  Cow  Pox  in  the  other,  what  an  interesting 
addition  to  his  paper  it  would  prove.  Secondly,  he 
may  have  wished  to  ascertain,  whether  by  successi\'e 
cultivation  in  the  human  subject,  protective  properties 
would  be  gradually  assumed  by  the  horse-grease  virus. 
For  his  experimental  purposes,  Jenner  selected  a 
child  five  years  old,  John  Baker  by  name,  and  on 
March  i6th,  1798,  he  took  matter  from  a  pustule  on 
the  hand  of  Thomas  Virgoe,  one  of  the  servants  who 
had  been  infected  from  the  mare's  heels. 

''  He  became  ill  on  the  sixth  day,  with  symptoms  similar  to 
those  excited  by  the  Cow  Pox  matter.  On  the  eighth  da}',  he 
was   free  from   indisposition. 

"There  was  some  variation  in  the  appearance  of  the  pustule 
on  the  arm.  Although  it  somewhat  resembled  a  Small  Pox 
pustule,  yet  its  similitude  was  not  so  conspicuous  as  when  excited 
by  matter  from  the  nipple  of  the  cow,  or  when  the  matter  has 
passed  from  thence  through  the  medium  of  the  human  subject." 

The  result  had  little  in  common  with  inoculated 
Small  Pox  ;  but  it  so  far  corresponded  with  inoculated 
Cow  Pox,  that  Jenner  was  encouraged  to  apj^ly  the 
variolous  test  to  ascertain  whether,  in  spite  of  his 
previous  conclusions,  the  system  had  been  rendered 
insusceptible  of  Small    Pox, 


270  EDWARD  JENNER. 


"  We  have  seen  that  the  virus  from  the  horse,  when  it  proves 
infectious  to  the  human  subject,  is  not  to  be  rehed  upon  as 
rendering  the  system  secure  from  variolous  infection,  but  that  the 
matter  produced  by  it  on  the  nipple  of  the  cow  is  perfectly  so. 
Whether  its  passing  from  the  horse  through  the  human  con- 
stitution, as  in  the  present  instance,  will  produce  a  similar  effect, 
remains  to  be  decided." 

Jenner,  of  course,  intended  to  apply  the  test  of 
variolous    inoculation,    and    to    watch    the    results. 

Now,  in  the  historical  case  of  James  Phipps,  the 
Cow  Pox  was  inoculated  on  the  14th  of  May;  on 
the  tenth  day,  he  was  said  to  be  perfectly  well. 
On  the  I  St  of  July  following,  that  is  to  say,  in  less 
than  seven  weeks  after  inoculation,  he  was  inoculated 
with  Small  Pox.  We  may  therefore  conclude  that, 
as  John  Baker  had  been  inoculated  on  the  i6th  of 
March,  and  was  said  to  be  free  from  indisposition 
eight  days  afterwards,  that  it  was  Jenner's  intention 
to   inoculate   him    on    or    about    the    ist    of   May. 

"  This  would  now  have  been  effected,  but  the  boy  was  rendered 
unfit  for  inoculation  from  having  felt  the  effects  of  a  contagious 
fever  in  a  workhouse  soon  after  this  experiment  was  made," 

The  question  naturally  arises,  whether  the  fever 
might  not  have  been  the  result  of  the  inoculation 
with  horse  grease.  What  was  the  meaning  of  "  con- 
tagious fever,"  and  why  this  vagueness  of  expression  } 
Jenner  was  well  acquainted  with  measles,  scarlet  fever, 
ulcerous  sore-throat  with  spotted  skin,  erysipelas, 
swine    pox,    chicken    pox,    and    other    fevers.      W^e    are 


PUBLISHED   "INQIVRY:'  271 


therefore  left  to  suppose  that  it  was  some  un- 
recognised form  of  "  fever,"  from  which  the  boy 
ultimately  recovered  ;  but  as  the  variolous  inoculation 
had  been  prevented  at  the  time,  the  history  of  the 
fever  was  not  worth  tracing,  although  further  details 
might  have  been  given,  for  the  Impiiry  was  not 
published    until    June    21st. 

It  is  not  until  we  read  Jenner's  Fin'thcr  Observations 
that  our  attention  is  again  drawn  to  this  niatter.  In  a 
reference^  to  this  case,  Jenner  insists  upon  the  "similarity 
to  the  Cow  Pox  of  the  general  constitutional  symptoms 
which  followed,"  and  in  a  footnote  we  read  : — 

"  The  boy  unfortunately  died  of  a  fever  at  a  parish  workliouse, 
before  I  had  an  opportunity  of  observing  what  effects  would  have 
been  produced  by  the  matter  of  Small  Pox." 

The  fact,  then,  of  the  boy's  death  was  omitted 
in  the  first  account,  and  this  is  the  full  meaning  of 
the    boy    being    "  rendered    unfit    for    inoculation." 

But  why  should  the  fact  of  the  boy's  death  have 
been  omitted  ?  Did  the  boy  die  from  the  eftects  of 
inoculation  ?  Let  us  revert  to  the  history  of  the  case. 
What  was  the  state  of  the  progress  of  the  vesicle  on 
the  boy's  arm  ?  No  description  is  given  in  the  Inquiry ; 
all  that  we  learn  is  that  the  syinptoins  were  similar  to 
those  excited  by  Cow  Pox  matter,  and  on  the  eighth 
day,  he  was  tl*ee  from  indisposition,  and  the  juistule 
"somewhat     resembled     a     Small     Pox     pustule."       On 

'  Vol.  ii.,  p.  169. 


EDWARD  JENNER. 


referring  to  the  coloured  illustration,  it  is  hardly- 
credible  that  the  lad  was  free  from  indisposition  on 
the  eighth  day  [Plate  IV.].  A  vesicle  is  depicted  with 
the  appearances  which  indicate  that  the  "vaccination" 
had  taken  severely.  Another  casual  reference^  in 
Ftu'ther  Observations,  throws  additional  light  on  this 
case.  Jenner  says  he  was  led  to  assume  the  origin  of 
Cow  Pox  from  the  grease,  partly  "  from  the  progress 
and  general  appearance  of  the  pustule  on  the  arm  of 
the  boy  inoculated  with  matter  taken  from  the  hand 
of  a  man  infected  by  a  horse."  Now,  if  it  progressed 
in  the  same  way  as  the  Cow  Pox  inoculation  on 
Phipps,  it  must  have  been  a  vesicle  surrounded  by 
an  efflorescence,  with  "  rather  more  of  an  erysipelatous 
look  than  we  commonly  perceive  when  variolous 
matter  has  been  made  use  of  in  the  same  manner  .  .  . 
leaving  on  the  inoculated  parts  scabs  and  subsequent 
eschars."  The  progress  of  the  vesicle  having  been 
compared  to  that  of  inoculated  Cow  Pox,  we  may 
conclude  that  it  ran  on  to  ulceration,  the  bane  of 
Jenner's  early  inoculations.  This  supposition  is  verified 
by  an  abstract,  published  by  Baron,  from  Jenner's 
manuscript  notes,  in  which  he  alludes  to  "  the  peculiar 
appearance  of  the  pustule,  and  its  disposition  to  run 
into  an  ulcer,  in  the  arm  of  the  boy  who  was  inocu- 
lated with  matter  taken  from  the  hand  of  a  man,  who 
received  the  infection  from  dressing  a  slight  spontaneous 


Vide  vol.  ii.,  p.  i( 


plait;  IV, 


''^ 


INOCULATED    HORSE    POX    ( JE  N  N  E  R). 
Case  of  John  Bakek. 


P  UB  LI  SHED   ' '  INQ  UIR  Y. ' ' 


sore  on  a  horse's  heel."  It  is  evident  that  in  the 
published  account  of  this  boy's  case.  Jenner  had  sup- 
pressed all  details  of  the  progress  of  the  vesicle, 
the  ulceration,  and  the  erysipelas,  as  well  as  the  fatal 
termination  of  the  case,  and  he  inserted  instead  that 
"  on  the  eighth  day  he  was  free  from  indisposition," 
])ut  "  was  rendered  unfit  for  inoculation  from  having 
felt  the  effects  of  a  contagious  fever." 

It  would  seem  most  probable  that  in  this  boy,  five 
years  old  (selected  by  Jenner  as  a  suitable  subject  for 
testing  his  speculations  as  to  the  progress  and  effects 
of  horse  grease),  a  large  vesicle  was  produced  which  ran 
on  to  ulceration,  that  the  angry  blush  developed  into 
erysipelas,  and  the  boy  died.^  But  his  death  was  attri- 
buted to  a  contao^ious  fever  cmiQ-ht  in  the  workhouse. 

Jenner    considered     that    his    former    cases    had    so 

satisfactorily    withstood    the    subsequent    inoculation    of 

Small    Pox    that    it    was    unnecessary    to    test    all    the 

subjects    of    these    later    experiments.       He,    however, 

inoculated     William     Summers,    but    the     date     of    the 

operation    and    the     local     results    are    not    mentioned. 

All   that   we    are  told    is,   that    the    system   did   not   feel 

the    effects    of    it.       Two    other    children,    Barge     and 

Pead,    were   inoculated    l)y   his    nephew,    Henry   Jenner. 

who   reported  as   follows  : — 

"On  the  second  day,  the  incisions  were  inflamed,  and  there  was 
a  pale  inflammatory  stain  around  them.     On  the  third  day,  these 


'  Compare  Crcighton.     Cow  Pox  and  Vaccinal  SyJ)/iilis,  p.  }^2. 
VOL.  I.  l^ 


274  EDWARD  yENJVER. 

appearances  were  still  increasing,  and  their  arms  itched  consi- 
derably. On  the  fourth  day,  the  inflammation  was  evidently 
subsiding,  and  on  the  sixth,  it  was  scarcely  perceptible." 

William  Summers  had  been  inoculated  from  the 
cow,   the  same  day   as   Baker. 

"He  became  indisposed  on  the  sixth  day,  vomited  once,  felt  the 
usual  slii^ht  symptoms  till  the  eighth  day,  when  he  appeared 
perfectly  well." 

From  William  Summers  the  disease  was  transferred 
to  William  Pead,  after  the  manner  of  arm  to  arm 
variolation.  From  William  Pead,  several  children  and 
adults  were  inoculated  ;  three  suffered  from  extensive 
erysipelatous  inflammation.  From  one  of  these 
patients,  Hannah  Excell,  matter  was  taken  and  in- 
serted into  the  arms  of  John  Marklove,  Robert  Y . 
Jenner,  Mary  Pead,  and  Mary  James.  From  Mary 
Pead  lymph  was  taken   to   inoculate   J.    Barge. 

PEDIGREE   OF  JENNERS    FIRST   STOCK   OF  LYMPH 
(EQUINE   INDIRECT). 

Horse 

I 
Cow 

..   .        ' 
William  Summers 

I 
William  Pead 

I 


1 

Hannah  Excell       Several  other  children 
I  and  adults 


1-- 


— I 1  Mr.  Cline's  patient. 

John  Robert  F.  Jenner       Mary       Mary  \ 

Marklove       [Failed  to  take]        Pead       James  (-- 


A  Child  A  Child 

J.  Barge  [Failed  to  take]     [Failed  to  take] 

[Stock  lost]. 


i 


FLATE   V.  I 


ml 


it, 

r 


.iF 


:0"' 


INOCULATED    HORSE    POX    (JENNER). 
Case  of  William  Pead. 


! 


Fclh'win;i  rUte.   V. 
PLATE   VI. 


^ 


.^^ 


Pt  fr 


INOCULATED     HORSE    POX     (JENNKR). 
Case  of  Hannah  Excell. 


PUBLISHED   ^'INQUIRYr  275 

Besides  adding  fresh  cases,  the  whole  manuscript 
was  carefully  revised.  With  regard  to  the  horse 
grease  theory,  Jenner  now  felt  himself  in  a  position 
to  speak  more  positively,  for  in  referring  to  the 
possible  transference  of  infectious  matter  froni  the 
horse's  heel  to  the  cow's  teat,  he  substituted  the  words 
when  this  is  the  case  for  should  this  be  the  case. 

Several  expressions  are  modified  in  his  description  of 
Cow  Pox.  In  his  paper,  he  had  written  that  the  pus- 
tules were  "  seldom  white,  but  more  commonly  blue,  and 
generally  surrounded  by  more  or  less  of  an  erysipelatous 
inflammation,"  but  the  published  Inquiry  reads: — 

"At  their  first  appearance,  they  are  commonl}^  of  a  palish 
blue,  or  rather  of  a  colour  somewhat  approaching  to  livid,  and 
are  surrounded    by  an   erysipelatous   inflammation." 

And    in    the    third    edition    of    the     Inquiry    the     word 
erysipelatous  is   omitted. 

Another  instance  of  modifvins^  oris^inal  statements  occurs 
in  the  description  of  the  case  of  Sarah  Wynne.  The 
account  in  the  original  paper  may  be  compared  side  by 
side  with   the  revised  version   in   the  published  Inquijy. 

Original    Paper.  Published  "  Inquiry." 

"  She  caught  the  complaint  "  She  caught  the  complaint 
from  the  cows,  and  was  affected  from  the  cows,  and  was  affected 
with  it  [Cow  Pox]  in  so  violent  with  the  symptoms  described  on 
a  degree  that  she  was  incapable  the  8th  page,  in  so  violent  a 
of  doing  any  work  for  the  space  degree,  that  she  was  confined  to 
of  ten  days."  her  bed,  and  rendered  incapable 

for  several  days  of  pursuing  her 
ordinary  vocations  on  the  farm." 


2-6  EDWARD  JENNER. 


Now  if  we  turn  to  the  symptoms  described  on  the 
2>th  page  we  are  referred  to  a  foot-note,  in  which  it  is 
stated  that  these  symptoms  arise  from  the  irritation 
of  the  sores,  and  not  from  the  primary  action  of  the 
vaccine  virus  upon  the  constitution.  The  meaning 
of  this  correction  is  now  apparent.  Jenner's  idea,  at 
this  period,  was  to  provide  a  mild  substitute  for  Small 
Pox  inoculation,  and  these  severe  symptoms  described 
in  the  original  paper  as  an  essential  part  of  the  Cow 
Pox  are  now  attributed  to   accidental   causes. 

This  system  of  modifying  his  original  observations 
is  adhered  to  throughout  the  paper.  The  sentence 
"  pustules  which  are  most  disposed  to  degenerate  into 
phagedenic  ulcers,"  now  reads  "pustules  which,  frequently 
degenerate  into  phagedenic  ulcers." 

But  one  of  the  most  important  alterations  is  the 
suggestion   of  a  spurious  Cow  Pox. 

Original  Paper.  Published  "  Inquiry." 

"  But  first  it  is  of  importance  "  It  is   necessary   to    observe 

to  remark   that  there  are  other  that  pustulous  sores  frequently 

causes  besides  contagious  matter  appear    spontaneously    on    the 

which     produce     pustules    and  nipples  of  cows,    and  instances 

sometimes    ulcerations    on    the  have     occurred,      though    very 

nipples    of    the    cows,    and    in-  rarely,    of    the    hands    of     the 

stances    have    occurred    of    the  servants    employed    in    milking 

hands  of  the  servants,  employed  being    affected    with    sores    in 

in    milking,  being  affected  with  consequence,  and  even  of  their 

sores  in  consequence,  and  even  feeling    an     indisposition     from 

of  their  feeling  an  indisposition  absorption.     These  pustules  are 

from  absorption.     But  instances  of  a  much   milder   nature   than 

are  very  rare.     This  complaint  those    which    arise    from    that 


P UBLISHED   '  •  J.\\)  UIK  Y. ' ' 


277 


appears  at  various  seasons  of 
the  year,  but  most  commonly 
in  the  spring,  when  the  cows 
are  first  taken  from  their  winter 
food  and  fed  with  grass.  It  is 
very  apt  to  appear  also  when 
they  are  suckling  their  3'oung. 
But  this  disease  is  not  to  be 
considered  as  having  any  kind 
of  connection  with  that  of  which 
I  am  treating,  as  it  is  incapable 
of  producing  an}'^  specific  effects 
on  the  human  constitution.  This 
distinction  between  the  two  dis- 
eases becomes  the  more  impor- 
tant as  the  want  of  it  might 
occasion  an  idea  of  security 
from  the  infection  of  the  Small 
Pox  which  would  prove  delu- 
sive." 


contagion  which  constitutes  the 
true  Cow  Pox.  Phe}'  are  always 
free  from  the  bluish  or  livid  tint 
so  conspicuous  in  the  pustules 
in  that  disease.  No  erysipelas 
attends  them,  nor  do  they  show 
any  phagedenic  disposition  as 
in  the  other  case,  but  quickly 
terminate  in  a  scab,  without 
creating  an}'  apparent  disorder 
in  the  cow.  This  complaint 
appears  at  various  seasons  of 
the  year,  but  most  commonly  in 
the  spring,  when  the  cows  are 
first  taken  from  their  winter 
food  and  fed  with  grass.  It  is 
apt  to  appear  also  when  they 
are  suckling  their  young.  But 
this  disease  is  not  to  be  con- 
sidered as  similar  in  any  respect 
to  that  of  which  I  am  treating, 
as  it  is  incapable  of  producing 
any  specific  effects  on  the  human 
constitution.  Mowever,  it  is 
of  the  greatest  consequence  to 
point  it  out  here,  lest  the  want 
of  discrimination  should  occa- 
sion an  idea  of  security  from 
the  infection  of  the  Small  Pox 
which  might  prove  delusive." 


Jenner  was  obviously  referring  in  the  original  paper 
to  the  Blister  Pock,  though  he  does  not  name  the 
disease.  But  in  the  paragraph  inserted  in  the  pub- 
lished Inquiry,  he  used  the  term  ti'iie  Cow  Pox  ior 
the  first   time,   which   leads   the  reader  to   suppose   that 


278  EDWARD  JENAER. 


the  disease  "  of  a  milder  nature "  was  a  false  Cow 
Pox.  And  at  the  conclusion  of  the  paper,  Jenner  has, 
no  longer,  any  hesitation  on  this  point,  but  uses  the 
terms  ti'ue  Cow  Pox  and  spnrio2is  Cow  Pox,  with 
a  reference  to  the  foot-note  which  has  been  quoted 
above. 

I  wish  to  insist  upon  the  gradual  assumption  of 
the  existence  of  a  spurious  Cow  Pox.  The  farmers 
and  cow  doctors  knew  nothing  of  this  spurious  Cow 
Pox.  They  distinguished,  from  other  eruptions  such  as 
blistered  teats,  a  disease  which  produced  troublesome 
ulcerations  on  the  cow's  teats,  and  ulcerations  on  the 
hands,  enlarged  glands,  and  constitutional  symptoms  in 
milkers,  and  this  disease  they  called  the  Cow  Pox. 
Jenner  was  alone  responsible  for  assuming  the  existence 
of  two  kinds  of  Cow  Pox,  a  true  and  a  spurious.  And 
this  assumption  was  extended  in  Further  Observations  to 
include  not  one  but  several  kinds  of  so-called  spurious 
Cow   Pox. 

In  a  subsequent  publication,  entitled  The  Origin  of 
the  Vaccine  Inoculation,  Jenner  has  given  the  history 
and  full   meaning  of  this  innovation  : — 

"  In  the  course  of  the  investigation  of  this  subject,  which,  Hke 
all  others  of  a  complex  and  intricate  nature,  presented  many 
difficulties,  I  found  that  some  of  those  who  seemed  to  have 
undergone  the  Cow  Pox,  nevertheless,  on  inoculation  with  the 
Small  Pox,  felt  its  influence  just  the  same  as  if  no  disease 
had  been  communicated  to  them  by  the  cow.  This  occurrence 
led  me  to  inquire  among  the  medical  practitioners  in  the 
country   around    me,   who  all   agreed   in   this  sentiment,   that  the 


PUBLISHED   ''INQUIRVr  279 


Cow  Pox  was  not  to  be  relied  upon  as  a  certain  preventive  of 
the  Small  Pox. 

"This  for  a  while  damped,  but  did  not  extinguish,  my 
ardour ;  for,  as  I  proceeded,  1  had  the  satisfaction  to  learn 
that  the  cow  was  subject  to  some  varieties  of  spontaneous 
eruptions  upon  her  teats ;  that  they  were  all  (5/r)  capable  of 
communicating  sores  to  the  hands  of  the  milkers,  and  that, 
whatever  sore  was  derived  from  the  animal,  was  called  in  the 
dairy  the  Cow  Pox. 

"  Thus  I  surmounted  a  great  obstacle,  and,  in  consequence,  was 
led  to  form  a  distinction  between  these  diseases  ;  one  of  which 
only  I  have  denominated  the  true,  the  others  the  spurious.  Cow 
Pox,  as  they  possess  no  specific  power  over  the  constitution." 

In  some  concluding  remarks,^  in  the  published  Inquiry, 
Jenner  relates  the  cases  of  Hannah  Pick  and  Elizabeth 
Sarsenet,  who  contracted  Cow  Pox,  with  all  the  other 
servants,  at  a  farm  in  the  parish  of  Berkeley. 

It  puzzled  Jenner  still  more  to  find  an  explanation 
for  these  cases,  for  Hannah  resisted  variolous  inocula- 
tion, so  the  Cow  Pox  was  pronounced  to  be  "  true  ;  " 
and  yet  when  Elizabeth  Sarsenet  was  exposed  to 
variolous  infection,  she  caught  the  disease. 

"This  impediment  to  my  progress  was  not  long  removed, 
before  another,  of  far  greater  magnitude  in  its  appearances, 
started  up.  There  were  not  wanting  instances  to  prove,  that 
when  the  true  Cow  Pox  broke  out  among  the  cattle  at  a 
dairy,  a  person  who  had  milked  an  infected  animal,  and  had 
thereby  apparently  gone  through  the  disease  in  common  with 
others,  was  liable  to  receive  the  Small  Pox  afterwards.  This, 
like  the  former  obstacle,  gave  a  painful  check  to  my  fond  and 
aspiring  hopes ;  but  reflecting  that  the  operations  of  nature 
are  generally  uniform,  and  that   it  was  not  probable   the  human 

'  Vide  vol.  ii.,  p.  2)2- 


28o  EDWARD  JENNER. 


constitution  (having  undergone  the  Cow  Pox)  should  in  some 
instances  be  perfectly  shielded  from  the  Small  Pox,  and  in 
many  others  remain  unprotected,  I  resumed  my  labours  with 
redoubled  ardour. 

The  result  was  fortunate ;  for  I  now  discovered  that  the 
virus  of  Cow  Pox  was  liable  to  undergo  progressive  changes, 
from  the  same  causes  precisely  as  that  of  Small  Pox,  and  that 
when  it  was  applied  to  the  human  skin  in  its  degenerated 
state,  it  would  produce  the  ulcerative  effects  in  as  great  a 
degree  as  when  it  was  not  decomposed,  and  sometimes  far 
greater ;  but  having  lost  its  specific  properties,  it  was  incapable 
of  producing  that  change  upon  the  human  frame  which  is 
requisite  to  render  it  unsusceptible  of  the  variolous  contagion  ; 
so  that  it  became  evident  a  person  might  milk  a  cow  one  day,  and 
having  caught  the  disease  be  for  ever  secure ;  while  another 
person  milking  the  same  cow  the  next  day,  might  feel  the  influence 
of  the  virus  in  such  a  way  as  to  produce  a  sore  or  sores,  and  in 
consequence  of  this  might  experience  an  indisposition  to  a  con- 
siderable extent ;  yet,  as  has  been  observed,  the  specific  quality 
being  lost,  the  constitution  would  receive  no  peculiar  impression." 

Jenner  adds  a  few  additional  notes.  He  reiterates 
his  conviction  that  Cow  Pox  alone  arises  from  the 
grease,  and  states  that  true  Cow  Pox  was  occasionally 
absent,  because  the  farmer's  horses  had  not,  from  the 
dryness  of  the  season,  been  affected  with  grease. 

In  another  paragraph,  he  repeats  his  belief  that 
Cow  Pox  is  not  self-protective,  and  gives  the  case 
of  Elizabeth  Wynne,  who  had  Cow  Pox  in  1759, 
was  inoculated  with  Small  Pox  without  effect  in  1797, 
and  caught  Cow   P©x  again  in    1 798. 

Jenner  adds  to  his  remarks  on  the  precautions  to  be 
observed  in  applying  the  variolous  test,  and  advocates 
the  more  moderate  method  of  Sutton. 


FUEL!  SHED   ''  INQUIRY  r  281' 


The  horse  grease  theory  was  supported  by  another 
case. 

"  An  extensive  inflammation  of  the  erysipelatous  kind 
appeared  on  the  upper  part  of  the  thigh  of  a  sucking  colt, 
and  terminated  in  the  formation  of  abscesses.  Those  who 
dressed  the  inflamed  parts  milked  the  cows.  They  all  had 
Cow  Pox,  and  the  milkers  were  infected  also." 

Jenner  adds  : — 

"  That  the  disease  produced  upon  the  cows  by  the  colt,  and 
from  thencp  conveyed  to  those  who  milked  them,  was  the 
true  and  not  the  spurious  Cow  Pox  there  can  be  scarcely  any 
room  for  suspicion  ;  yet  it  would  have  been  more  completely 
satisfactory  had  the  effects  of  variolous  matter  been  ascer- 
tained on  the  farmer's  wife,  but  there  was  a  peculiarity  in 
her  situation   which  prevented  my  making  the  experiment." 

The  Inquiry  concludes  with  the  following  para- 
graph :— 

"  Thus  far  have  I  proceeded  in  an  inquiry  founded,  as  it 
must  appear,  on  the  basis  of  experiment ;  in  which,  however, 
conjectures  have  been  occasionally  admitted,  in  order  to  present 
to  persons,  well  situated  for  such  discussions,  objects  for  a 
more  minute  investigation.  In  the  meantime,  I  shall  myself 
continue  to  prosecute  tliis  inquiry,  encouraged  by  the  hope  of 
its  becoming  essentially  beneficial  to  mankind."' 

We  may  now  sum  up  the  cases  which  were  added 
to  the  original  paper. 


CASUAL   COW 

POX. 

Natne. 

Inoculated  with 
Small  Pox. 

Date  of 
Cow  Pox. 

William  Stinchcomb     . 

■      1792 

.   10  years  previously 

Hester  Walkley    . 

•      1795 

•  13       .. 

Seven  paupers  of  Totworth  . 

•      1795       • 

.   "  different  period.'  . 

Sarah  Nelmes 

May  1796. 

EDWARD  JENKER. 


CASUAL   HORSE   GREASE. 

Name.  Date  of  Horse  Grease. 

Thomas  Virgoe  .......     \ 

William  Wherret  .......!    February  1798. 

William  Haynes .     ) 

INOCULATED   HORSE   GREASE  (EQUINE  DIRECT). 

John  Baker  ........     March  i6th,  1798 

(Died). 

INOCULATED  HORSE  GREASE  (EQUINE  INDIRECT). 
William  Summers March  i6th,  1798. 

William  Pead March  28th,     ,, 

i 

Hannah  Excell  (and  1 

several  other  chil-  \     .....         .     April  5th. 

dren  and  adults)  ) 

I -" -r -r 1 

John  Robert  F.        Mary  Mary  .         .     April  12th. 

Marklove        Tenner         Pead  Tames 

I 
J.  Barge 

In  the  previous  chapter,  I  have  analysed  the  contents 
of  Jenner's  original  paper,  and  concluded  that  the 
Council  of  the  Royal  Society  was  perfectly  justified  in 
rejecting  it.  It  is  true  that  in  the  original  paper, 
Jenner  could  lay  claim  to  priority  of  publication  of 
an  account  of  the  symptoms  of  the  casual  Cow  Pox 
in  the  cow  and  in  man,  but  he  could  not  lay  claim 
to  the  theory  of  the  origin  of  Cow  Pox  from  grease. 
He  could  lay  claim  to  being  the  first  to  publish  the 
experimental  transmission  of  Cow  Pox  to  the  human 
subject.  We  have  now  to  consider  whether  the 
additions  to  the  paper,  when  published,  contained 
anything  which  could  be  claimed  as  a  discovery.  This 
was  undoubtedly  the  case.  He  could  lay  claim  to  the 
discovery    that    Horse   Pox,  like    Small    Pox,   could    be 


PUBLISHED   ''INQUIRVr  283 


carried  on  from  arm  to  arm,  throup^h  a  number  of 
individuals,  a  fact  wliich,  so  far  as  we  know, "was  new  to 
the  traditions  and  experience  of  the  country  people. 

That  this  is  a  just  estimate  of  what  was  oriizinal 
in  his  work,  is  verified  by  the  fict  that  when  Jenner 
published  his  account  of  the'  origin  of  the  vaccine 
inoculation,  he  laid  no  claim  to  the  discovery  of  Cow^ 
Pox  or  of  its  alleged  protection  against  Small  Pox, 
but  only  that  it  could  be  experimentally  inc^ulated  in 
the  human  subject. 

"  During  the  investigation  of  the  casual  Cow  Pox,  I  was  struck 
with  the  idea  that  it  might  be  practicable  to  propagate  the  disease 
by  inoculation  after  the  manner  of  the  Small  Pox,  first  from  the 
cow,  and  finally  from  one  human  being  to  another." 

In  the  propagation,  by  inoculation,  from  the  cow  to 
the  human  subject,  he  had  been  anticipated  by  Jesty 
and  others  ;  so  that  the  two  main  points  of  the  inquiry 
were,  that  he  was  the  first  to  carry  on  a  series  of 
arm  to  arm  equinations,  and  he  was  the  first  to 
advocate   in  print  the  adoption  of  this   new  inoculation. 

We  are  now  in  a  position  to  estimate  what  Jenner's 
researches  amounted  to,  up  to  the  time  of  the  inquiry. 
Jenner  himself  gives  1776  as  the  date  of  the  com- 
mencement of  his  inquiry,  and  says  nothing  of  the 
Sodbury  incident.  In  this  year,  inoculation  by  the 
Suttonian  method  became  very  general  in  Gloucester- 
shire. Jenner's  attention  was  drawn  to  a  case  ot 
insusceptibility  which,  in  accordance   with  the   provincial 


284  EDWARD  JENNER. 


rumour,  was  attributed  to  a  previous  attack  of  Cow  Pox. 
But  he  does  not  appear  to  have  paid  much  attention  to 
the  subject  until  1780,  when  he  repeated  the  provincial 
tradition  in  London,  and  showed  a  drawing  of  the 
eruption  on  the  hand  of  a  milker.  But  about 
1 79 1  (about  seven  years  before  the  publication  of  the 
Inquiry),  he  had  again  turned  his  attention  to  Cow 
Pox,  and  between  1791  and  1795,  he  had  collected 
four  more  cases  of  insusceptibility  to  the  inoculated 
Small  Pox. 

In  1790,  Cow  Pox  broke  out  in  a  dairy  near  Berkeley, 
and  Jenner  took  the  opportunity  to  inoculate  Phipps. 
Then  his  inquiries  were  stopped  until  1798,  when  horse 
grease  broke  out  at  a  neighbouring  farm,  and  John 
Baker  was  inoculated  and  died.  William  Summers, 
inoculated  with  horse  grease  passed  through  the  cow, 
survived,  and  the  virus  was  carried  on  from  arm  to 
arm   through   several  patients. 

The  cases  are  carelessly  jumbled  together  ;  important 
details  are  often  missing  ;  dates  are  omitted  ;  facts  un- 
favourable to  the  project  are  suppressed  ;  and  excuses 
for  failures  are  ingeniously  incorporated.  All  that  the 
Inquiry  contained  was  known  to  dairymaids  and  farriers, 
with  the  exception  of  the  doctrine  of  spurious  Cow 
Pox,  and  certain  speculative  comments.  All  that  was 
added  experimentally,  to  what  had  been  previously 
practised,  was  the  inoculation  of  Horse  Pox  from  arm 
to  arm,   in  imitation  of  arm  to  arm  variolation.      Up  to 


PUBLISHED   ''INQUIRY:'  285 


the  year  1 796.  Jenner  had  simply  collected  notes  of 
a  few  cases  of  milkers  and  others,  who  had  had 
either  Horse  Pox  or  Cow  Pox,  and  had  resisted  in- 
oculation with  Small  Pox,  and  Posbrooke  tells  us  that 
up  to  this  date  he  was  not  burdened  with  work.  In 
the  same  year,  he  made  one  exi-kklment  of  inoculation 
on  the  human  subject,  and  hurriedly  wrote  a  paper 
which  was  rejected  by  the  Royal  Society.  Two  years 
later,  he  carried  on  a  series  of  arm  to  arm  inoculations, 
and   then   published  the  Inquiry  on  his  own   account. 

These  are  the  dry  facts  of  the  case,  which  Baron 
sums   up  as  follows  : — 

"  If  we  look  at  the  origin  of  this  discovery  from  its  first  dawning 
in  his  3^outhful  mind  at  Sodbur}',  and  trace  it  through  its  subse- 
quent stages — his  meditations  at  Berkeley — his  suggestions  to  his 
great  master,  John  Hunter — his  conferences  with  his  professional 
brethren  in  the  country — his  hopes  and  fears,  as  his  inquiries  and 
experiments  encouraged  or  depressed  his  anticipations — and,  at 
length,  the  triumphant  conclusion  of  more  than  thirty  years'  reflection 
and  study,  by  the  successful  vaccination  of  his  first  patient,  Phipps ; 
we  shall  find  a  train  of  preparation  never  exceeded  in  any  scientific 
enterprise;  and  in  some  degree  commensurate  with  the  great 
results  by  which  it  has  been  followed. 

And  in  more  recent  times  this  extraordinary  out- 
burst  of  rhetoric   has   been   officially   endorsed.^ 

"  Among  the  dairy-folks  of  Gloucestershire  there  was  a  curious 
tradition  .  .  .  that  persons  who  had  suffered  from  this  Cow  Pox, 
as  it  was  called,  were  by  it  rendered  insusceptible  of  Small  Pox. 


Simon.     History  and  Practice  vf  Vaccination.     1857. 


EDWARD   -JEA'^NER. 


Words  to  this  effect  were  once  spoken  in  the  hearing  of  Edward 
Jenner,  then  a  village  doctor's  apprentice  in  the  neighbourhood  of 
Bristol.  They  were  never  afterwards  absent  from  his  mind.  Thirty 
years  elapsed  before  their  fruit  was  borne  to  the  public ;  but  inces- 
santly he  thought  and  watched  and  experimented  on  the  subject ;  and 
the  work  on  which  at  length  he  recorded  the  incomparable  results 
of  his  labour  may  well  have  commanded  the  confidence  of 
reflecting  persons. 

"Little  would  ever  be  heard  of  objections  to  vaccination  if  all 
who  undertake  the  responsibility  of  its  performance,  and  all  who 
feel  disposed  to  resist  its  adoption  would  but  thoroughly  study 
that  masterpiece  of  medical  induction,  and  imitate  the  patience  and 
caution  and  modesty  with  which  Jenner  laid  the  foundation  of 
every  statement  he  advanced. 


-iw 


CHAPTER    IX. 

human  small  pox  as  a  source  of  "  vaccine 
lymph:' 

SY^ENIIA^r     was     th(j      first      to      distinguish     different 

varieties  of  Small  Pox.     Adams  ^  experienced  (outbreaks 

,of  what    the    nurses    called    the    white    sort,    which    he 

believed    to    be    the    same    as    a    variety    mentioned   by 

Sydenham,   which    left    no   marks.     A  similar    outbreak 

which    prevailed    in  Gloucestershire  was  referred    to  by 

lenner.      The  attack   was  as   mild   as   in   the   inoculated 

Small    Pox,    and    the    lower  classes   of  people  were    so 

little  afraid  of  it  that  social   intercourse  was   maintained 

iis  usual.      The  nurses  and  common  people  called  it  the 

Swine  or   Pig   Pox. 

According  to   Adams,  the  pustules  of  this  variety  are 

never  very  large,  but  round  and  unitorm   in   projjortion 

as    the    disease    is     well     marked.       As    they    increase, 
* 

the  ui)per  surface  extends  over  the  base,  and  as  they 
dry.  the  scab  becomes  nearly  globular.  The  scab  is 
of  a  pale  amber  colour,  and  dries  much  harder  than 
in    the     common     distinct    disease.       From    the     figure, 

'  Adams.    A  Popular  Vie'w  of  Vaccine  Inoctclat ion.    1807. 


HUMAN  SAiALL   FOX. 


colour,  and  other  properties  preserved  throughout  the 
whole  progress,  Adams  called  this  variety  the  pearl  sort. 

In  the  chapters  on  Small  Pox  inoculation,  I  have 
drawn  attention  not  only  to  the  various  methods  of 
inoculation,  but  also  to  the  different  results  which 
followed  the  employment  of  virus  of  different 
strengths. 

Inoculators  had  learnt  by  experience  tliat  it  was 
not  advisable  to  take  matter  from  the  confluent 
Small  Pox,  as  a  severe  attack  would  probably  follow  ; 
and,  therefore,  in  the  directions  given,  It  is  constantly 
recommended  that  a  mild  sort  of  Small  Pox  should 
alone  be  used.  In  the  hands  of  the  Suttons,  inoculation 
became  still  milder,  because  they  were  always  careful 
to  inoculate  with  variolous  lyinph  ;  and  as  Sutton 
was  said  to  have  been  more  successful  in  his  early 
practice,  it  is  probable  that  the  success  largely  depended 
upon  the  accidental  circumstance  of  having  first  started 
his  Inoculations  with  matter  from  an  outbreak  of  a 
very  mild  Small  Pox,  and  the  mild  character  of  this 
variety  was,  for  a  time,  successfully  propagated  from 
arm  to  arm.  Adams  ^  obtained  still  more  striking- 
results,    which    I    will    relate    In    his    own    words. 

"  By  continuing  with  great  caution  to  inoculate  at  the  hospital 
from  pearl  Small  Pox,  and  afterwards  by  selecting  those  arms 
which  had  the  most  appearance  of  Cow  Pox,  we  at  last  succeeded 
in  procuring  a  succession  of  arms  so  nearly  resembling  the  vaccine, 
that   an   universal    suspicion    prevailed    among    the    parents,  that 

'  Adams,  he.  cit.,  p.  27. 


PLATE   VU. 


^^^Trt*^ 


rtK 


YW^  day 


(0 


X^  iy 


XVIfi^d? 


w 


XX^ciay. 


COW    POX.  SMALL    POX. 

(Ballhorn  and  Stkomevkr). 


Zjirjxf-.ir^&AuriS-nJ  ^ 


' '  VA  CCINE  L  YMPH. "  289 


they  were  deceived  by  the  substitution  of  one  for  the  other.     This 
will  be  readily  understood  by  the  following  register  : 

"  Register  I. 

"August  14th,  1805,  William  Croft  was  inoculated,  with  several 
others,  from  a  subject  who  had  casual  Small  Pox.  Croft  had 
diarrhoea  three  days  after  he  was  inoculated,  a  circumstance  in 
children  often  favourable  for  the  future  disease. 

"  On  the  3rd  day,  the  insertion  appeared  elevated. 

"  6th,  a  vesicle. 

"  8th,  the  vesicle  spread. 

"  1 0th,  has  a  vaccine  appearance  with  fe/er. 

"  13th,  one  hundred  and  fifty  pustules  appeared  which  passed 
regularly  through  their  stages,  somewhat  shortened,  as  often 
happens  in  inoculation. 

"  Rogers  was  inoculated  26th  August,  from  Croft,  in  two  places. 
Only  one  took  eftect,  which  w^as  perfectly  vaccine  in  all  its  stages. 
The  child  had  been  previously  ill,  so  that  it  was  difficult  to 
ascertain  whether  any  or  what  degree  of  constitutional  disorder 
was  produced  by  the  inoculation. 

"  Mary  Ann  Dobins,  having  been  previously  inoculated  from 
Croft  w^ithout  effect,  was, 

"September  2nd,  inoculated  from  Rogers.  The  arm  proved 
vaccine  in  all  its  stages. 

"  On  the  same  day,  were  inoculated  from  Rogers — 

"  I.   Richard  Jude.     His  arm  was  vaccine  in  ever}-  stage. 

"  On  the  13th  day,  as  the  arm  was  drying,  appeared  one  hundred 
and  fifty  variolous  pustules. 

"  II.   Eleanor  Watts.     Arm  vaccine. 

"  Pustules  appeared  on  the  iith  da}-, 

"On  the  13th,  five  hundred  were  counted;  all  maturated,  hut 
dried  earl}-. 

"  III.  Elizabeth  Gray.  Iler  arm  regularl}' vaccine  to  the  8th 
day. 

"On  the  loth,  appeared  stationar}-,  in  consequence  of  which 
inoculation  was  repeated  from  Edward  Christian's  arm,  who  had 
been  inoculated  twelve  days. 

"  1 2th  day,  the  arm  first  inoculated  retains  its  vaccine  appearance, 

VOL.    I.  19 


290  HUMAN  SMALL   POX. 


though  somewhat  jagged  with  elevations  round  the  vesicle.     She 
had  fever  the  day  before,  and  pustules  first  appeared  on  the  body. 

"  13th,  the  arm  retains  its  circumscription,  but  is  yellow.  The 
fever  considerable  all  night. 

"14th,  the  first  inoculation  dry;  the  second  contains  a  3'ellow 
crystalline  lymph  with  areola.  Has  upwards  of  sixty  small 
circumscribed  pustules. 

"  15th,  arms  drying,  pustules  suppurating. 

"  19th,  pustules  drying. 

"  22nd,  scabbed. 

"  IV.  Thomas  Dyson.  His  arm  was  perfectly  vaccine  in  all  its 
stages. 

"  lOth  day,  a  few  pustules  appeared  ;  had  been  sick  on  the  9th 
evening. 

"  1 2th  day,  the  arm  drying. 

"  From  Dobins,  seven  were  inoculated  ;  of  these 

"  Five  had  no  eruption  ;  the  arms  were  vaccine  in  all  the  stages, 
and  in  the  appearance  of  the  scab. 

"  One  had  a  perfectly  vaccine  appearance  on  the  arm,  areola,  and 
brown  scab,  with  one  hundred  variolous  pustules,  which  appeared 
on  the  1 2th  day,  and  began  to  dry  on  the  i6th  ;  but  the  desic- 
cation was  not  completed  till  the  29th,  when  the  appearance  was 
horny. 

"  The  other  had  a  vaccine  arm  somewhat  irregular,  with  fever, 
but  no  pustules. 

"  From  the  last,  were  inoculated  four. 

"Of  these,  two  had  vaccine  arms,  perfect  in  all  their  stages,  and 
without  pustules. 

"  One  had  the  vaccine  vesicle  regular,  excepting  that  the  edges 
sloped  in  such  a  manner,  that  the  base  was  broader  than  the 
apex.  The  top  was,  however,  flat,  and  the  whole  appearance  such 
as  occasionally  occurs  in  the  genuine  vaccine. 

"The  other  had  small  pustules,  which  dried,  as  well  as  the  place 
of  insertion,  by  the  15  th. 

"  Elizabeth  Gray,  we  have  observed,  had  pustules.  Two  were 
inoculated  from  her  arm,  and  two  from  her  pustules. 

"  The  two  from  the  arm  had  the  legitimate  vaccine  appearance. 
"  One,  from  the  pustules,  had  fever  with  general  efflorescence. 


"  VACCINE  LYMPH r  291 

"The  other  had  all  the  symptoms  of  vaccination,  with  the 
areola  ;  but  the  contents  of  the  vesicle  became  yellow  before  it 
dried. 

"  It  is  unnecessary,  in  this  place,  to  pursue  this  register  any 
further.  Suffice  it  to  say  that  the  enemies  to  vaccination,  about 
this  time,  excited  so  great  a  clamour  that  every  mother  was 
suspicious  lest  her  child  should  be  clandestinely  inoculated 
with  the  Cow  Pox  ;  and  even  those  who  saw  matter  taken 
from  secondary  pustules,  and  applied  to  the  arm,  were  scarcely 
satisfied  unless  their  own  children  had  unequivocal  symptoms 
of  Small  Pox.  Reflecting,  therefore,  that  an  event  of  this 
kind  must  either  occur  again,  or  be  unsatisfactory  from  being 
unsupported,  w^e  contented  ourselves  with  the  record  preserved  in 
the  register,  waiting  till  it  should  be  explained  b}^  subsequent 
occurrences. 

"  This  is  not  the  only  time  that  we  have  been  interrupted  in 
our  attempt  to  perpetuate  a  favourable  Small  Pox.  For  though 
it  was  urged  to  the  parents,  that  before  the  discovery  of  Cow 
Pox,  the  inoculation  of  the  Small  Pox  was  sometimes  only 
followed  by  a  pustule  at  the  arm,  with  the  attendant  fever ;  yet 
the  suspicions  of  many  were  equal  to  their  prejudices  :  nothing 
less  than  secondary  pustules  would  satisfy  them,  and  some 
even  expressed  their  doubts,  if  the  eruption  was  scanty  or 
disappeared  early." 

It  was  not  until  many  years  afterwards,  that  Guillon^ 
also,  found  that  a  vesicle,  with  the  physical  charac- 
ters of  the  vaccine  vesicle,  could  be  raised  from  Small 
Pox  by  cultivation. 

Dr.  Thiele,  of  Kasan.  in  1839,  succeeded  in  the 
following  manner.  Lymph  from  human  Small  Po.x 
was  allowed  to  remain,  for  ten  days  between 
slips     of     glass    fastened    together    with      wax.         'I'he 

'   The  Lo7id(m  Medical  Repository  and  Review,  p.  426.     1827. 


292  HUMAN  SMALL   FOX. 

virus  was  then  diluted  with  warm  cow's  milk,  and 
inoculated  like  ordinary  vaccine  lymph.  Large 
vesicles  resulted.  There  were  febrile  symptoms  from 
the  third  to  the  fourth  day,  and  a  secondary  onset 
of  fever,  much  more  pronounced,  between  the  eleventh 
and  the  fourteenth  days.  The  areola  was  strongly 
marked,  and  not  confined  to  the  inoculated  place 
which  was  occasionally  surrounded  by  minute  secondary 
vesicles.  The  scar  was  larger  and  deeper  than  usual, 
and  the  edges   occasionally  sharply  defined. 

If  watched  through  ten  removes,  the  vesicles  were 
found  gradually  to  assume  all  the  classical  characters 
of  the  vaccine  vesicle.  As  soon  as  the  secondary 
fever  ceased  to  occur,  inoculation  from  arm  to  arm  was 
practised  without  diluting  the  lymph   with  cow's  milk. 

This  variety  of  vaccine  lymph  was,  later,  designated 
lacto-variohne .  That  a  "  vaccine  vesicle "  could  be 
produced  direct  from  human  Small  Pox,  without,  that 
is  to  say,  the  intervention  of  the  cow.  was  regarded 
as  an  extraordinary  and  novel  fact.  But  the  results 
were  precisely  the  same  as  those  obtained  by 
Adams  and  by  Guillon,  which,  so  far  as  I  am  aware, 
had  been  entirely  overlooked.  The  production  of  a 
"  vaccine  vesicle  "  from  a  mixture  of  variolous  lymph 
and  milk  was  not  vaccination  in  the  strict  meaning 
of  that  term,  but  simply  variolation  in  an  extremely 
mild    form. 

Precisely    similar    results    were    ol3tained    by    Gassner 


"  VACCINE  LYMPHr 


=93 


in  1801,  who  succeeded  in  reducing  the  effects  of  Small 
Pox  virus  to  the  production  of  "vaccine  vesicles"  on 
one  out  of  eleven  cows  which  had  been   inoculated. 

The  ordinary  phenomena  of  vaccination  were  ob- 
served in  four  children  inoculated  from  this  cow, 
and  similar  results  followed  in  seventeen  children 
inoculated  from  them. 

In  1828,  Dr.  McMichael  reported  to  the  Royal 
College  of  Physicians  that  several  physicians  in  Egypt, 
had  succeeded  in  raising  ''  vaccine  lymph  "  by  inocula- 
tion of  cows  with  Small  Pox,  and  that  children  were 
successfully  "  vaccinated." 

In  1830,  Dr.  Sonderland,  of  Barmen,  claimed  to 
have  produced  vaccine  in  cows  by  infection  from 
human  Small  Pox.  An  account  of  these  experiments 
was  published  in  the  Medical  Repository,  with  the 
following  introduction  : — 

"The  author  of  the  paper  which  we  shall  here  translate 
almost  without  abridgement,  if  his  experiment  be  correct,  has 
at  length  succeeded  in  establishing  what  physicians  have  long 
laboured  to  discover,  a  satisfactory  and  simple  explanation  of 
the  protective  power  of  Cow  Pox  against  Small  Pox,  and,  as 
announced,  we  will  venture  to  say,  the  most  important  discovery 
which  has  been  made  in  the  pathology  of  these  diseases  since 
vaccination  was  first  introduced,  by  showing  that  they  are 
modifications  of  one  another,  and  that  Cow  Pox  in  the  cows 
is  simply  Small  Pox  in  man,  and  may  be  produced  in  that 
animal  at  will  by  the  variolous  contagion.  Of  the  authenticity 
of  his  facts  we  don't  pretend  to  judge  ;  all  we  can  say  is  that 
the  author,  if  we  judge  from  the  language  of  Boufleu  towards 
him,  is  a  respectable  practitioner,   and  a  public  medical  officer." 


294  HUMAN  SMALL   POX. 

"'The  simplest  and  surest  mode  of  producing  Cow  Pox  in 
the  cow,  and  thus  proving  indisputably  the  identity  betvv^een 
the  contagion  of  Cow  Pox  and  that  of  human  Small  Pox,  is 
to  follow  the  procedure  here  laid  down.  Take  a  woollen 
bedcover  which  has  lain  on  the  bed  of  a  Small  Pox  patient 
who  has  died  during  the  suppurating  stage,  or  is  suffering  from 
the  disease  in  a  considerable  degree,  and  is  lying  in  a  small 
imperfectly-ventilated  apartment ;  and,  when  it  is  well  penetrated 
by  the  contagion,  roll  it  up  immediately  after  death  or  the 
fourteenth  da}^  of  the  disease  ;  wrap  it  in  a  linen  cloth,  and 
then  spread  for  twenty-four  hours  on  the  back  of  a  quey  in 
such  manner  that  it  cannot  be  thrown  off  by  the  animal,  then 
place  it  for  twenty-four  hours  on  the  backs  of  each  of  three  other 
quays,  and  afterwards  hang  in  such  manner  in  their  stalls  that 
its  exhalation  may  rise  upwards  and  be  inhaled  by  them.  In 
a  few  days  the  animal  will  fall  sick  and  be  seized  with  fever  ; 
and  on  the  fourth  or  fifth  da}^,  the  udders,  and  other  parts 
covered  with  hard  skin,  will  present  an  eruption  of  pustules 
which  assume  the  well-known  appearance  of  Cow  Pox,  and 
become  filled  with  lymph.  This  lymph,  which  exactly  re- 
sembles the  lymph  of  genuine  Cow  Pox,  if  used  for  inoculating 
the  human  subject,  will  induce  the  vaccine  or  protective  pock. 
The  only  precaution  which  it  is  necessary  to  observe  is  that 
the  person  about  to  be  inoculated  should  not  be  exposed  in 
any  manner  to  the  contagious  effluvia  of  the  cow-house,  either 
directly  or  during  the  intervention  of  the  experimentalist's 
clothes,  otherwise  he  may  have  natural  Small  Pox.  A  bed- 
cover, impregnated  with  the  variolous  contagion,  if  firmly 
rolled  up  and  wrapped  in  linen,  and  afterwards  in  paper,  and 
then  properly  packed  in  a  bucket,  will  retain  the  contagion  for 
at  least  two  years,  so  as  to  infect  the  cow  with  Cow  Pox,  pro- 
vided it  can  be  kept  in  a  cool  shady  place,  where  the  temperature 
does  not  fall  under  thirty-two,  or  above  fifty-two,  degrees. 

" '  My  present  occupations  prevent  me  at  this  particular  period 
from  giving  a  full  and  scientific  exposition  of  the  consequences 
which  must  follow  from  this  discovery,  but  I  may  state  them 
shortly  in  the  aphoristic  form  : — 

"  *  I.  This  discovery  is  new;  for,  although  many  have  suspected 


"  VACCINE  LYAIPHr  295 


the  identit}-  of  Small  Pox  in  man  and  Cow  Pox  in  t!ie  cow,  and 
have  in  consequence  performed  inoculation  with  the  matter  of 
both,  yet  no  one  has  previously  ascertained  the  possibility  of 
transmitting  the  contagion  to  the  cow  in  the  gaseous  form  so 
as  to  decide  the  question  beyond  all  doubt. 

"  '  2.  The  desire  of  physicians  and  governments  to  discover 
Cow  Pox  in  cows,  in  order  to  revive  the  vaccine  lymph  is  more 
than  fulfilled  by  the  discovery  of  a  simple  method  of  engendering 
Cow  Pox  into  the  cow  at  will. 

"  *  3.  Jenner's  discovery  of  the  protective  power  of  vaccination 
hitherto  imperfect,  is  now  perfected,  because  the  previously 
unknown  nature  and  origin  of  Cow  Pox  are  laid  open. 

"'4.  All  previous  uncertainty  regarding  the  quality  of  vaccine 
matter,  its  degeneration,  the  loss  of  its  protective  property,  and 
the  like,  must  now  cease,  because  we  have  obtained  a  clear 
insight  into  the  nature  of  Cow  Pox,  and  can  lay  down  a  sub- 
stantial theory  of  its  operation. 

" '  5.  This  discovery  must  tend  to  widen  the  boundaries  of 
physiology,  pathology,  and  therapeutics,  since  it  shows  how  the 
subtle  contagion  of  Small  Pox  was  hostile  to  the  nervous  system 
of  man  ;  may  be  conveyed  in  the  aeriform  state  from  him  to  the 
cow,  and  excite  in  that  animal  a  similar  disease ;  but  in  doing  so, 
be  changed  by  the  special  constitution  of  this  class  of  animal  into 
a  permanent  contagion  of  a  different  kind. 

"  '6.  An  instructive  lesson  ma}^  be  drawn  from  this  discovery, 
how  the  poison  of  diseases  in  the  gaseous  form  may  be  commu- 
nicated to  the  lower  animals,  and  according  to  the  difference  in 
their  constitution,  engender  diversified  products  which  may  then 
be  used  as  protective  means  against  the  diseases  from  which  they 
originated.  Such,  for  example,  may  be  subsequently  proved  of 
scarlet  fever,  measles,  yellow  fever,  and  plague. 

"'  7.  It  is  now  clear  why,  in  recent  times.  Cow  Pox  has  been 
seldom  or  never  seen  in  the  cow  ;  for  the  Cow  Pox  of  the  cow 
arises  merely  from  infection  by  the  variolous  exhalations  from 
men  recently  affected  with  Small  Pox  and  coming  in  contact  with 
the  cow.  As  epidemics  of  Small  Pox  have  been  rare  during  the 
last  thirty  years,  cows  could  seldom  be  exposed  to  infection,  and 
have  therefore  seldom  exhibited  the  disease.' " 


HUMAN  SMALL    POX. 


Although  attempts  to  confirm  Dr.  Sonderland's  ex- 
periments failed  in  the  hands  of  Ceely  in  England, 
and  Macpherson  and  Lamb  in  India,  and  at  Alfort, 
Berlin,  Weimar,  Bergen,  Dresden,  Kasan,  Utrecht,  and 
Stockholm  on  the  Continent ;  nevertheless,  his  aphorisms 
were  accepted  in  support  of  the  theory,  the  popular 
doctrine  of  the  present  day,  that  Cow  Pox  is  Small 
Pox,  modified  by  transmission  through  the  cow.  Had 
Dr.  Sonderland  and  his  followers  been  acquainted  with 
the  characters  of  the  natural  Cow  Pox,  and  had  they 
appreciated  the  fact  that  a  vesicle  with  the  physical 
characters  of  the  vaccine  vesicle,  could  be  produced  on 
the  human  subject,  by  management  of  variolous  lymph 
without  the  intervention  of  the  cow,  they  could  hardly 
have  come  to  such  a  conclusion.  But  this  doctrine, 
owing  to  the  explanation  it  afforded  of  the  alleged 
protective  power  of  Cow  Pox  against  Small  Pox,  was 
a  most  seductive  one.  It  was  very  widely  accepted,  and 
led  to  a  complete  misinterpretation  of  the  successful 
variolation  experiments  which  followed. 

Dr.  Thiele  made  a  number  of  attempts  to  inoculate 
cows  with  variolous  virus,  and,  at  last,  succeeded 
in  producing  a  vesicle  with  the  physical  characters 
of  the  vaccine  vesicle.  P'rom  this  he  raised  a 
stock  of  lymph,  which  at  the  time  of  his  publica- 
tion had  passed  through  seventy-five  generations,  and 
had  been  used  for  the  "  vaccination "  of  over  three 
thousand     individuals.       Thiele    succeeded     in    confirm- 


"  VACCINE  LYMPHr  29; 


iiig  his  first  results.  He  insisted  iii)on  the  necessity 
of  selectinty  the  animals.  Cows  from  four  to  six 
years  old,  which  had  recently  calved,  and  those  with 
delicate  pink  skins,  were  preferred.  The  udder  was 
shaved,  and  variolous  lymph  was  alone  employed,  and 
the    animals    were    exposed     to    a    proper    temperature 

(■5°  R-)- 

Before  Dr.  Thiele's  experiments  were  published 
in  this  country,  Mr.  Ceely  of  Aylesbury,  impressed 
with  Dr.  Sonderland 's  seventh  aphorism,  and  influenced 
by  tJie  strong  presumptive  evidence  of  Baron  that  Small 
Pox  had  been  common  to  men  and  brutes,  determined 
to  test  the  validity  of  Dr.  Sonderland's  experiments. 

Attempts  to  infect  cows  by  enveloping  them  with 
the  sheets  and  blankets  of  Small  Pox  patients  were 
without  result.  Ceely  nevertheless  persevered,  and 
proceeded  to  try  the  effect  of  variolous  inoculation. 

In  order  to  avoid  all  sources  of  error,  Ceely  himself 
took  the  Small  Pox  virus  in  the  presence  of  his 
assistant,  Mr.  Taylor,  on  points  that  could  never  have 
been  used  before,  as  they  were  the  teeth  of  a  large 
comb  cut  for  the  purpose.  Lymph  was  also  collected 
in  new  capillary  tubes.  This  lymph  was  inoculated  on 
one  side  of  the  vulva  of  a  heifer,  and  Cow  Pox  lymph 
on  the  other.  One  of  the  variolous  punctures  deve- 
loped into  an  enormous  vesicle,  very  unlike  an  ordinary 
vaccine  vesicle.  There  can  be  no  doubt  that  Ceely 
succeeded    in    raising    a    variolous    vesicle.      But     it     is 


298  HUMAN  SMALL   POX. 

very  commonly  supposed  to  have  had  a  vaccinal 
origin,  from  the  lancets  having  been  mixed,  or  the 
vaccine  transferred  to  the  opposite  side  by  the  animal's 
tail. 

The  variolous  character  of  this  vesicle  was  fully 
borne  out  by  the  result  of  the  accidental  inoculation 
of  his  assistant. 


"  My  assistant,  Mr.  Taylor,  to  whom  I  had  entrusted  the  lancet 
used  in  opening  the  variolous  vesicle  in  the  first  experiment,  on 
the  tenth  day,  while  I  was  engaged  in  the  tedious  process  of 
charging  points  thereform,  punctured  the  skin  of  his  own  hand, 
between  the  thumb  and  forefinger,  with  the  instrument  while 
moist  with  lymph,  a  circumstance  with  which  at  the  time  I  w^as 
unacquainted.  On  the  fourth  day  afterwards,  he  directed  my 
attention  to  a  hard,  deep  red,  papular  elevation  on  the  spot, 
stating  the  cause,  and  at  the  same  time  assuring  me  that  he  had 
been  vaccinated  in  infancy,  and  had  subsequently  had  modified 
Small  Pox.  On  the  fifth  day,  there  was  a  papulo-vesicular  eleva- 
tion, surrounded  with  a  dark  red  areola,  and  much  uneasiness 
in  the  part.  In  the  evening,  headache  and  other  febrile  symptoms 
appeared,  with  roseola  and  fiery  red  papulse  on  the  face  and 
other  parts.  On  the  sixth  day,  a  more  diff"used  and  lighter  areola 
suri'ounded  the  less  abrupt  elevation,  which  w'as  now  more  per- 
fectly vesicular ;  the  constitutional  symptoms  increased,  and  the 
papulae,  on  the  face,  neck,  trunk,  and  limbs,  exhibited  ash-coloured 
summits,  and,  through  a  lens,  appeared  to  have  slight  central 
depressions.  On  the  seventh  day,  it  was  manifest  that  the 
disease  had  reach  its  acme  on  the  previous  day.  The  areola 
was  diminished,  the  vesicle  was  more  apparent,  some  of  the 
papulae  presented  straw-coloured  summits,  and  the  roseola  was 
declining,  with  an  abatement  of  the  febrile  symptoms,  a  diminu- 
tion of  the  tenderness  of  the  axilla.  On  the  eighth  day,  all  these 
changes  were  more  obvious,  although  he  was  not  free  from  head- 
ache ;  the  papulae  were  more  yellow   and  some  were  desiccating  ; 


VARIOLATION     OF    THE    COW     (CEELY). 


"  VACCINE  LYMPHr  29^ 

the    vesicles    were    larger    but    less    active,    and    the    areola    was 
comparatively  pale." 

Chauveau,  also,  is  of  opinion  that  Mr.  Taylor  had 
an  attack  of  Small  Pox,  and  no  doubt  this  is  the 
true  interpretation  of  what  occurred.  But  Ceely's 
eyes  were  blinded  by  Sonderland's  seventh  aphorism. 
He  looked  upon  this  giant  vesicle  as  the  experimental 
confirmation  of  the  doctrine  that  Cow  Pox  is  modified 
Small  Pox,  and  hence  the  opinion  he  expressed  of 
Mr.  Taylor's  case,  "this  was  evidently  modified  vaccine 
in  a  sanguine  habit,  with  roseola  and  vesicular  or 
vaccine  lichen." 

Points  charged  with  lymph  from  the  variolous  vesicle 
were  used  on  children.  "  \^accine  vesicles  "  were  pro- 
duced with  the  primary  constitutional  symptoms  slight, 
and  the  secondary,  proportioned  to  the  extent  and 
character  of  the  areola.  One  child  who  suffered  severely, 
had  vomiting  and  delirium  and  extensive  roseola,  but 
no  eruption  was  observed    in  any  other  case. 

In  December,  1840,  Mr.  Badcock,^  of  Brighton, 
quite  independently  of  Ceely,  succeeded  in  variolating 
a  cow.  He  was  led  to  undertake  the  experiment 
from  havinLT  suffered  from  a  danQ;erous  attack  ot 
Small  Pox  in  1836,  which  impressed  his  mind  with 
the  view  "  that  the  old  vaccine  had  lost  its  protective 
influence  by  passing  through  so  many  constitutions." 
After     making     inquiries     with    a    view     to    raising     a 

•  Vol.  ii.,  p.  513  ct  seq. 


3C0  HUMAN  SMALL   POX. 


fresh  stock  of  vaccine  from  the  cow,  he  came  to 
the  conclusion  that  the  only  satisfactory  way  would 
be  to  inoculate  a  cow  with  Small  Pox  matter.  in 
the  month  of  December  1840,  he  inoculated  a  fine 
young  cow.  on  the  teats  and  on  the  external  labium, 
with  .Small  Pox  virus.  No  details  of  the  operation 
have  been  recorded,  but  the  result  was  successful. 
There  was  one  well-developed  vesicle  on  the  external 
labium,  and  the  lymph  from  it  was  employed  by 
Badcock  for  "  vaccinating  "  his  son.  The  case  excited 
considerable  interest,  and  more  than  thirty  members  of 
the  profession  examined  the  boy.  In  four  years, 
Badcock  was  able  to  repeat  this  experiment  upon 
upwards  of  ninety  cows,  and,  from  occasional  successful 
cases,  to  raise  fresh  supplies  of  "  vaccine."  According 
to  the  testimonials  published  by  Badcock,  there  were 
slight  differences  observed,  by  several  physicians,  on 
comparing  the  vesicles  with  those  produced  by  the 
current  vaccine  lymph.  Badcock  ultimately  successfully 
variolated  37  out  of  200  cows  experimented  upon. 
The  vesicles  were  only  perfect  in  2)Z^  '^^^  these  cases 
furnished  lymph  for  400  practitioners.  In  1857,  it  was 
estimated  that  14,000  people  had  been  "vaccinated" 
with  Badcock's  lymph,  and  subsequently  it  was  stated 
that  Badcock  himself  had  "vaccinated"  upwards  of 
20,000  individuals. 

It   is  quite   a   mistake   to   speak   of  this   operation   as 
vaccination.       This   method   was    simply    a    modification 


VACCIKE  LYMPH r  301 


of  the  Sutton icin  system  of  Small  Pox  inoculation, 
in  which,  in  the  first  remove,  the  cow  was  substituted 
for  the  human  subject.  I  repeat,  that  all  those  who 
have  been  inoculated  with  Ceely's  or  Badcock's 
"variola-vaccine"  lymph  have  not.  in  the  true  sense 
of  the  word,  been  vaccinated ;  they  have  not  been  Coiu 
Poxed,  but  they  have  been  variolated.  This  is  amply 
verified  by  the  results  which  have  followed  in  tht: 
hands  of  others  who  have  variolated  cows,  and  used 
the    products    for    "  vaccination." 

In  1836.  Dr.  ]Martin.  of  Attleborou^^h,  Mass.,  inocu- 
lated the  cow's  udder  with  variolous  lymph,  and  by 
inoculating  children  from  the  variolated  cow,  produced 
an  epidemic  of  Small   Pox  with  fatal  cases. 

In  1839,  Reiter,  of  Munich,  after  fifty  unsuccessfijl 
attempts,  succeeded  in  producing  a  vesicle  with  all 
the  characters  of  the  vaccine  vesicle.  The  variolous 
lymph  which  had  been  employed  in  that  case,  when 
inoculated  into  another  cow,  gave  rise  to  results 
similar  to  those  obtained  by  Chauveau.  A  child  ino- 
culated from  the  successful  vesicle,  contracted  Small 
Pox. 

In  1847,  variolation  of  the  cow  was  successfully 
performed  at  Berlin,  but  the  |)roducts  inoculated  in 
the  human  subject  resulted  in  reiro-variolisation.  and 
one  of  the  experimental  children  died  ot  confiuent 
Small    Pox. 

In    1864.   the   Lyons   Commission   enc(Aintered  similar 


302  HUMAN  SMALL   POX. 


disasters.  Chauveau,  in  his  classical  experiments, 
made  in  the  name  of  the  Lyons  Commission, 
1863  —  1865,  inoculated  seventeen  animals  with 
virulent  variolous  lymph  {en  pleine  actiz'ild).  He 
obtained  very  small  papules,  which  became  insignificant 
in  the  second  remove.  The  contents  of  these  papules 
inoculated  into  children  always  produced  Small  Pox, 
which  recalled,  in  its  course,  the  results  obtained  by 
the  early  inoculators  of  Small  Pox.  One  of  the 
children  transmitted  Small  Pox  to  another  child, 
who  communicated  it  to  the  mother.  Some  of  the 
children  died.  In  1871,  Chauveau  produced  precisely 
similar  results.  He  inoculated  Small  Pox  and  Cow 
Pox  on  the  same  animal.  The  Small  Pox  virus  still 
produced  Small  Pox,  and  the  Cow  Pox  virus  produced 
Cow  Pox.  The  two  viruses  mixed  and  inoculated  in 
bovines  engendered  Cow  Pox  only  ;  and  a  similar  result 
was  obtained  in  children  after  six  successive  transmis- 
sions through  the  cow.  Chauveau  therefore  believes  in 
the  autonomy  of  Cow  Pox  ;  in  other  words,  in  the 
impossibility  of  transforming  Small  Pox  into  Cow  Pox. 
More  recently,  Voit,  at  the  vaccination  station  at 
Hamburg,  succeeded  in  producing  "  variola-vaccine." 
He  inoculated  a  calf  with  Small  Pox  lymph  and  Cow 
Pox  lymph,  on  parts  of  the  body  far  distant  from  each 
other.  The  variolous  lymph  had  been  collected  on 
the  fourth  day.  The  Cow  Pox  took  feebly  ;  the  punc- 
tures, for  the  most  part,  were  abortive,   but  those  which 


VACCINE  LYMPlir  303 


developed,  took  the  ordinary  course.  Of  five  inocu- 
lations with  \ariolous  lymph,  tour  failed  entirely,  the 
fifth  was  transt^onned  into  a  lart^e,  round,  ij^reyish 
\esicle,  llattened,  but  not  uiiihilicated.  On  the;  sixth 
day,  it  measured  six  millimetres.  The  areola  was 
indistinct.  It  was  excised  on  the  sixth  day,  and  the 
contents  inoculated  on  the  scrotum  of  a  calf,  three 
months  old,  and  very  fine  vesicles,  with  the  characters 
of  vaccine  vesicles,  resulted.  After  successive  culti- 
vation on  calves  through  twenty  generations,  the  only 
ciifference  in  this  virus  front  ordinary  vaccine  lymph 
was  its  slightly  greater  activity.  But  lymph  taken  from 
the  second  remove  produced,  in  a  child,  marked  fever 
after  the  sixth  day,  and  acute  eczema  on  the  letl: 
knee  ;  on  the  ninth  day,  swollen  glands  in  the  axilla, 
and  on  the  twelfth  and  sixteenth,  eruptions  {pelites 
nodositcs  dissemiites),  which  indicated  its  true  variolous 
character. 

The  lymph  from  the  third  remove  of  calves,  inocu- 
lated on  four  children,  produced  in  three,  serious 
complications,  erysipelas,  angina,  and  pneumonia.  With 
lymph  of  the  eighth  remove,  accidents  continued  to 
follow,  but  happily  no  deaths  occurred.  V'oit  was  ot 
opinion  that  the  pustulous  eruptions  [ptisiules  dc 
vaviola-iaccine)  which  resulted  on  inoculation  of  the 
variolous  virus  in  a  cow,  was  true  Small  Pox  of  the 
cow,  and  that  the  nodular  exanthem  described  by 
Chauveau  was  to  be  considered   as  an  abortive   form. 


304  HUMAN  SMALL   POX. 


From  the  mere  resemblance  which  existed  between 
late  removes  of  "variola-vaccine"  and  ordinary  vac- 
cine, Voit  believed  that  he  had  succeeded  in 
transforming  Small  Pox  into  Cow  Pox.  Voit  was 
misled  by  appearances,  in  precisely  the  same  way  as 
Ceely,  and  others  who  have  succeeded  in  reducing 
Small  Pox  to  the  appearances  of  a  vaccine  vesicle. 
The  true  variolous  character  of  the  "variola-vaccine" 
lymph,  and  the  tendency,  in  less  early  removes,  to  pro- 
duce Small  Pox,  is  probably  the  reason  why  Voit 
has  abandoned  its  use,  in  favour,  as  I  am  informed 
by  M.  Layet,  of  the  ordinary  spontaneous  Cow  Pox 
lymph,  from   the  vaccination  station   at   Rotterdam. 

The  doctrine  that  Cow  Pox  is  modified  Small  Pox 
was  adhered  to  with  extraordinary  tenacity,  and  it 
became  the  official  dogma  that,  as  Small  Pox  pro- 
tected against  Small  Pox,  so  Cow  Pox,  being  modified 
Small  Pox,  must  of  necessity  protect  against  Small 
Pox.  Even  distinguished  pathologists  and  scientists 
were  misled,  and  the  doctrine  was  all  the  more 
acceptable  in  that  it  met  a  host  of  objections.  It 
is  interesting  now  to  look  back  and  see  the  reception 
meted  out  to  Chauveau's  opposite  conclusions.  Dr. 
Seaton,  for  example,  in  his  Handbook  of  Vaccination, 
1865,  thus  speaks  of  M.    Chauveau's  experiments: — 

"  With  serosity  taken  from  one  of  the  cows  and  one  of  the 
horses,  local  vesicles,  followed  by  general  varioliform  eruption, 
were  in   fact  produced  on  three  children,  and  from  these  children 


"  VACCINE  LYMPH r  305 

other  variolous  inoculations  were  performed.  These  results  are 
regarded  by  the  experimenters  as  showing  that  the  inoculation 
of  variola  on  horses  and  cows  produces  a  true  variolous  infection, 
and  that  the  organism  of  these  animals  is  therefore  incapable  of 
transforming  variola  into  vaccine.  But  they  do  not  appear  to  me 
to  lead  at  all  necessarily  to  the  conclusions  thus  drawn.  The 
local  effects  produced  by  these  inoculations  were  not  in  any 
respect  greater  than  those  produced  by  Ceely  in  cases  which  he 
regarded  as  failures,  nor  than  the  results  which  followed  some 
variolous  inoculations  of  horses  (two)  performed  in  1863  by 
MM.  Le  Blanc  and  De  Paul,  which  were  regarded  by  them  as 
unsuccessful.  And  it  is  not  in  the  least  improbable  that  if  Mr. 
Ceely,  or  MM.  Le  Blanc  and  De  Paul  had,  in  the  cases  they 
describe,  dealt  with  the  tumid  papules  that  arose  as  M.  Chauveau 
and  his  colleagues  did,  the\^  might  have  got  from  them  the  same 
stuff  {sic)  they  had  put  in — stuff  which  had  undergone  no  sort  of 
transformation  whatever,  but  which  had  lain  where  it  was  put 
as  in  a  pouch,  quite  inert,  giving  rise  only  to  local  irritation, 
without  inducing  any  sort  of  general  affection  or  disease." 


l]ut  Chauveau  was  perfectly  correct.  The  eruption 
which  follows  inoculation  of  bovines  with  Small  Pox, 
whether  papular  or  vesicular,  is  still  variolous.  Ceely, 
Badcock,  Chauveau,  Voit,  and  others  succeeded  in 
ingrafting  Small  Pox  on  the  cow,  and  when  suitable 
lymph  and  suitable  subjects  were  employed,  a  more 
or  less  benign  vesicle  resulted.  And  they  ought  to 
have  known  that  similar  results  had  been  obtained 
on  the  human  subject  by  Sutton  emd  Dimsdale,  and 
identical  results  by  Adams,  without  transmission 
through    the   cow. 

I,  therefore,  agree  with  Chauveau,  with  the  ex- 
ception  of  his  statement  that   the  persons   so  variolated 

vol..  I.  20 


w6  HUMAN  SMALL   POX. 


must  necessarily  convey  infection.  This  is  only  partly 
true  ;  it  is  not  necessarily  the  case,  as  is  amply  borne 
out  by  the  experience  with  Badcock's  lymph.  In 
this  case,  there  has  been  no  tendency  for  the  inocu- 
lated to  spread  variola  by  infection,  proving  that  a 
strain  of  benign  variolous  lymph  can  be  cultivated 
by  judicious  selection,  and  completely  deprived  of 
any  infectious  properties. 


I 


CHAPTER   X. 

CATTLE   PLAGUE   AS   A     SOURCE    OF    ''VACCINE 
LYMPH r 

Baron  states  in  reference  to  the  affinities  alleged  to 
exist  between  Cow  Pox  and  Small  Pox,  that  in  no 
former  instance  did  historical  evidence  and  remarkable 
pathological  phenomena  so  singularly  and  beneficially 
throw  light  on  each  other. 

In  this  chapter.  I  propose  to  inquire  into  the  his- 
torical evidence  collected  by  Baron,  and  to  ascertain 
whether  his  literary  researches  justified  his  opinion,  and 
in  what  way  they  affected  the  practice  of  vaccination. 

Jenner  always  considered  that  Small  Pox  and  Cow 
Pox  were  modifications  of  the  same  distemper ;  and 
Baron,  in  an  elaborate  dissertation,  not  only  endeav- 
ours to  justify,  but  to  fully  establish,  the  doctrine  of 
variolcs  vaccince.  I  have  already  pointed  out  the 
train  of  thought  which  led  Jenner  to  speak  of  Cow 
Pox  as  variolse  vaccinae.  b>om  the  similarity  of  the 
inoculated  Cow  Pox  to  the  inoculated  Small  Pox.  he 
concluded    that    these    two    diseases   were    derived   from 


3o8  CATJLE  PLAGUE. 


a  source  in  common.  He  believed  that  "grease,"  by 
successive  transmission  through  the  human  subject, 
became  Small  Pox,  but,  transmitted  through  the  cow, 
it  manifested  itself  in  the  form  of  Cow  Pox.  Cow 
Pox  might,  therefore,  in  this  sense  be  regarded  as 
Small    Pox  of  the  cow. 

Baron  took  an  entirely  different  ground  for  the 
establishment  of  this  doctrine.  He  reasoned  in  this 
way.  Eruptive  diseases  affecting  man  and  the  lower 
animals,  had  been  known  at  different  times,  and  in 
different  countries.  Just  as  there  were  numerous 
writers  on  Small  Pox  in  man,  so  there  were  also 
many  who  had  described  an  eruptive,  pestilential  disease 
existing  among  animals,  especially  cattle,  to  which  they 
applied  the  name  Variola.  The  question  then  was 
whether  the  variolas  of  men  and  of  the  lower  animals 
were  essentially  and  originally  the  same. 

In  order  to  elucidate  this  question,  Baron  ^  made  an 
elaborate  investigation  into  the  history  of  this  cattle 
disease.  He  quotes  Lancisi,  who  asserted  in  his 
treatise,  De  Bovilla  Peste,  that  this  disease  among 
horned  cattle  was  epidemic  in  the  Papal  Territory  in 
I  713  and  1 7 14,  and  was  similar  to  the  outbreak  which 
occurred  in  Italy  nearly  two  centuries  before,  of  which 
PVascatorius  had  given  a  description.  In  1690, 
Ramazzini  described  this  disease,  and  gave  the  following 
account   of  an   outbreak    in    Italy    in    171  i  : — 

'  Baron,  loc.  cit. 


"  VACCINE  LYMPH."  309 


"The  kind  of  affection  which  seemed  to  have  declared  exter- 
minating war  on  the  whole  race  of  oxen,  was  evidently  a 
malignant,  destructive,  and  (if  you  will)  a  pestilential  fever 
commencing  with  chills,  rigor,  horripilatio,  succeeded  quickly  by 
pungent,  violent  heat  diffused  over  the  whole  body,  with  frequency 
of  pulse,  and  accompanied  by  great  anxiety  and  heavy  panting, 
together  with  stertor,  and,  in  the  commencement  of  the  fever,  with 
stupor  and  a  kind  of  lethargy  ;  a  continual  flow  of  stinking  matter 
from  the  mouth  and  nostrils  ;  a  most  foetid  discharge  from  the 
bowels,  and  this  at  times  bloody  ;  loss  of  appetite  and  rumination 
was  altogether  destroyed ;  on  the  fifth,  or  sixth  day,  pustules 
broke  out  over  the  whole  body  of  the  animal,  and  tubercles 
resembling  variolce  in  kind  and  appearance ;  death  common  to 
all,  and  in  the  same  manner,  about  the  fifth  or  seventh  day  ;  a 
very  few  escaped,  and  these  rather  by  chance  than  the  efficacy 
of  any  remedies." 

Baron  also  quotes  from  the  account  published  by 
Dr.   Layard  in  the  PhilosopJiical  Transactions  for  1  780. 

*'  The  disease  among  horned  cattle  is  an  eruptive  fever  of  the 
variolous  kind :  it  bears  all  the  characteristic  symptoms,  crisis 
and  event  of  the  Small  Pox ;  and  whether  received  by  contagion, 
or  by  inoculation,  has  the  same  appearance,  stages,  and  deter- 
mination, except  more  favourable  by  inoculation,  and  with  this 
distinctive  and  decisive  property,  that  a  beast  once  having  had 
the  sickness,  naturally  or  artificially,  never  has  it  a  second  time. 

"  According  to  the  several  prejudices  of  different  countries, 
various  opinions  have  arisen  of  the  nature  of  this  sickness.  Such 
as  are  averse  to  inoculation,  have  obstinately  refused  to  acknow- 
ledge it  was  similar  to  the  Small  Pox  in  the  human  body,  and 
have  ver}-  idly  asserted,  that  the  only  intention  of  declaring  this 
contagion  to  be  a  species  of  Small  Pox,  was  purposely,  and  with 
no  other  view  than  to  promote  inoculation  for  the  Small  Pox. 
Others  have  as  positively  declared  it  to  be  a  pestilential  putrid 
fever,  owing  to  a  corrupted  atmosphere,  and  arising  from  infected 
pastures.  But  unfortunately  for  the  supporters  of  this  opinion, 
while  the  contagious  distemper    raged  with   the   utmost  violence 


310  CATTLE  PLAGUE. 


on  the  coasts  of  Friesland,  North  and  South  Holland,  Zealand, 
and  Flanders  there  was  not  the  least  appearance  of  it  on  the 
English  coast,  from  the  North  Foreland  to  the  H umber,  although 
the  coast  and  climate  are  the  same." 

This  destructive  disease,  so  graphically  described  by 
Dr.  Layard,  appears  to  have  been  first  noticed  in 
England  in  the  year  1745,  and  it  was  said  to  have 
been  imported  from  Holland.  I  may  continue  Baron's 
argument   in  his  own  words.  H 

"  When  Dr.  Layard  wrote,  it  was  of  less  importance  than  it 
is  now,  to  illustrate  the  connection  between  the  diseases  of  man 
and  the  inferior  animals ;  no  trials,  therefore,  were  made  to 
ascertain  whether  the  variolce  of  man  could  be  communicated  to 
the  brute,  or  vice  versa.  The  discovery  of  the  Variolae  Vaccinae 
has  fully  established  the  latter  point ;  and  although  attempts  to 
demonstrate  the  former  have  failed  in  the  hands  of  some,  other 
investigators  have  been  more  successful.  ...  It  was  quite 
unlocked  for,  and  at  first  almost  an  incredible  thing  that  a  disorder 
immediately  derived  from  one  of  our  domestic  animals  should 
exert  an  influence  so  powerful  and  so  beneficial  on  the  human 
frame.  But  if  it  should  appear  that  the  disease  incident  to  man 
and  to  beasts,  had  one  common  origin,  and  that  an  analogy, 
close  and  well-defined,  may  be  traced  in  their  subsequent  history 
and  progress,  we  shall  have  obtained  evidence  to  explain  patho- 
logical facts  which  are  of  the  utmost  value  to  mankind. 

"  From  what  has  been  adduced,  it  is  clear  that  a  fatal,  pestilential, 
eruptive  disease,  common  to  man  and  the  inferior  animals,  has 
been  known  from  the  earliest  period  of  authentic  history ;  that 
the  same,  or  at  least  a  disease  somewhat  similar,  continues  to 
exist  in  various  regions  of  the  earth,  often  attended  with  great 
mortality.  That  it  appears  to  have  undergone  various  modifica- 
tions in  respect  to  virulence,  and  to  be  susceptible,  by  artificial 
communication,  of  still  greater  modifications. 

"  Should  it  appear  that  the  views  which  I  have  attempted  to 
illustrate  rest  upon  a  solid  foundation,   they   will  tend,   I   would 


• '  VA  CCINE  L  YMFH:  '  311 

hope,  to  give  a  stability  to  the  practice  of  vaccine  inoculation 
which  was  not  formerly  experienced.  They  will  also  explain 
how  sheep  and  horses  or  any  other  animals  may  be  subject  to 
the  disease  as  well  as  cows  or  oxen ;  that  it  is  not  a  poison 
peculiar  only  to  one  variety,  but  may  be  found  and  propagated 
among  many.  It  will  not,  therefore,  excite  surprise,  that  matter 
capable  of  producing  the  genuine  pustules  should  be  found  in 
the  horse,  as  it  unquestionably  has  been  in  this  country  and 
elsewhere ;  or  that  the  disease  should  make  its  appearance  among 
sheep,  as  it  is  reported  to  do  in  Persia,  and  in  goats  in  other 
countries.  .  .   . 

"As  the  existence  of  the  Variolae  Vaccinae  in  the  dairies  of 
England  would  seem  not  to  have  been  of  very  long  duration, 
I  think  there  is  good  ground  for  believing  that  the  disease,  as 
originally  noticed  by  Dr.  Jenner  in  Gloucestershire,  was  the 
endemic  or  local  remains  of  the  more  general  or  epizootic  disease 
which  prevailed  in  man}'  parts  of  the  island  at  the  period  when 
Dr.  Layard  wrote." 

Baron  was  Chairman  of  the  Vaccination  Committee 
of  the  British  Association,  and  in  its  report  these 
views  are  araln  brousfht  forward,  and  there  was  no 
hesitation  In  speaking  of  Cow  Pox  as   Cozu  Small  Pox. 

In  order  to  make  this  account  agree,  to  some 
extent,  with  Jenner's  belief  in  the  origin  of  Cow  Pox 
from  the  horse's  heel.  Baron  says  that  he  regarded 
this  doctrine  as  substantially  true.  He  considered  that 
It  had  been  established  by  unquestionable  evidence 
that  matter  from  the  horse  produced  a  vesicle  similar 
in  appearance  to  the  vaccine  vesicle ;  but,  that  this 
fact,  though  it  proved  In  his  opinion  the  Identity  of 
the  diseases,  did  not  establish  the  fact  of  their  both 
originating  in  the  horse. 


CATTLE  PLAGUE. 


"  It  seems  certain  that  there  are,  at  least,  four  animals — the 
horse,  the  cow,  the  sheep,  and  the  goat — which  are  affected  with 
a  disorder  communicable  to  man,  and  capable  of  securing  him 
from  a  malignant  form  of  the  same  disease." 

The  disease  which  Baron  was  describing  was  not 
Cow  Pox  but  cattle-plague,  and  the  totally  erroneous 
views  into  which  he  had  drifted,  arose  from  that 
initial  nosological  error  committed  by  Jenner,  who 
branded  Cow  Pox  as  Variolcz  Vaccines,  or  Small  Pox 
of  the  Cow.  That  cattle-plague  has  a  close  affinity 
with  human  Small  Pox  is  perfectly  true,  but  it  has  no 
relation  or  connection  whatever  with  Cow  Pox.  I 
shall  give  a  brief  history  of  the  disease  referred  to 
by  Baron,  and  then  I  shall  pass  on  to  describe  the 
disastrous  results  which  followed  the  reception  of  the 
variolce  vaccines  theory  in   India. 

The  outbreak  of  cattle-plague,  described  by  Dr. 
Layard,  commenced  in  England  in  1745,  and  died  out  at 
the  end  of  twelve  years  ;  it  did  not  reappear  until  the 
summer  of  1 765.  In  1 769,  the  disease  was  again  so  preva- 
lent and  fatal  as  to  be  referred  to  by  George  III.  in  his 
.speech  at  the  opening  of  Parliament,  in  January  1770. 

The  resemblance  of  cattle-plague  to  human  Small 
Pox  had  long;  been  recognised,  and  this  view  was 
endorsed  in  more  recent  times  by  Murchison,^  who 
fegarded  the  analogy  as  very  close.  He  pointed  out 
that    Small 'Pox;  is    the    only  acute    contagious    disease 

'  Re;porf  of  the  Commissioners  appointed  to   inquire  into   the   Origin 
and  Nature,  etc.,  of  Cattle  Plague,  i86(),  p.  74,  cf  scq. 


VACCINE  LYiMPIir  313 


in  man  that  assumes  a  pustular  form.  The  eruption 
in  rinderpest  also,  consists  of  pustules  and  scabs,  while 
such  difterences  as  exist,  may  be  explained  by  the 
differences  in  the  skin  of  man  and  cattle,  and  are  not 
greater  than  the  differences  which  exist  between  varieties 
of  human   Small   Pox.      Murchison  continues  : — 

"  In  both,  the  eruption  extends  from  the  skin  to  the  interior 
of  the  mouth  and  nostrils  ;  in  both,  tlie  pustules  and  the  scabs 
are  preceded  or  accompanied  by  patches  of  roseola ;  in  both, 
they  are  occasionally  interspersed  with  petechiae ;  and  in  both, 
they  sometimes  leave  behind  pitted  scars  and  discolorations  on 
the  cutis.  .  .  .  The  other  prominent  symptoms  of  rinderpest  are 
also  those  of  Small  Pox,  viz.,  pyrexia,  lumbar  pain,  saliva- 
tion, and  running  from  the  nostrils ;  alvine  flux,  albuminuria, 
haematuria,  and  '  the  typhoid  state.'  The  anatomical  lesions 
of  the  internal  organs  in  rinderpest  and  unmodified  Small 
Pox  are  identical,  viz.,  congestion  or  inflammation  of  the 
mucous  membranes  of  the  air  passages  and  digestive  canal, 
patches  of  ecchymosis  and  even  gangrene  of  the  stomachs,  and 
other  mucous  surfaces,  and  dark  coloured  blood.  ...  In  both 
rinderpest  and  Small  Pox,  the  duration  of  the  pyrexial  stage  is  on 
an  average  about  eight  days.  In  both  diseases,  a  peculiarly  of- 
fensive odour  is  exhaled  from  the  body  before  and  after  death. 
The  perspiration  and  other  secretions  of  healthy  cattle  smell  very 
difterently  from  those  of  man,  so  that  we  can  readil}-  under- 
stand how  the  same  disease  may  generate  very  dift'erent  odours 
in  the  two  animals.  It  may  be  mentioned  that  a  medical 
correspondent  in  the  country  compared  the  smell  of  rinderpest 
to  that  of  human  variola  weeks  before  he  was  aware  of  the 
intimate  resemblance  of  the  two  maladies.  .  .  .  The  two  diseases 
resemble  one  another  in  their  extreme  contagiousness,  and  in 
the  facilit}'  with  which  the  poison  is  transmitted  by  fomites. 
Both  diseases  can  be  easily  propagated  by  inoculation,  and  in 
both  cases  the  inoculated  disease  is  milder  and  less  fatal  than 
that    resulting    from    infection.      In     both    diseases,     there    is    a 


314  CATTLE  PLAGUE. 


period  of  incubation  which  is  shorter  when  the  poison  has  been 
introduced  by  inoculation  than  when  it  has  been  received  by 
infection.  Vaccinated  persons  are  constantly  exposed  to 
Small  Pox  poison  with  impunity ;  and  with  regard  to  rinder- 
pest, there  are  numerous  instances  in  which  individual  cattle 
or  entire  herds  have  appeared  to  lead  charmed  lives  in  the 
midst  of  surrounding  pestilence.  This  last  fact  has  never 
been  explained,  but  it  would  be  readily  accounted  for  on  the 
supposition  that  rinderpest  was  the  equivalent  of  Small  Pox, 
and  that  the  cattle  who  have  enjoyed  the  immunity  from  it 
had  previously  suffered  from  ordinary  Cow  Pock." 

Murchison  admitted,  that  the  theory  that  rinder- 
pest was  simply  bovine  Small  Pox  might  be  objected 
to,  on  the  ground  that  there  was  no  proof  that  it  had 
communicated  Small  Pox  to  the  human  subject,  and 
that,  in  fact,  human  Small  Pox  was  far  less  prevalent 
in  1866,  than  it  was  a  few  years  previously,  when  there 
was  no  rinderpest.  Ceely,  however,  like  Baron, 
maintained  that  cattle-plague  was  simply  malignant 
Cow  Pox  ;  and  he  did  so  principally  from  the  fact  that 
in  the  accidental  transmission  of  rinderpest  to  the 
human  subject,  a  vesicle  was  produced  presenting  the 
appearances,  and  running  the  ordinary  course,  of  in- 
oculated Cow  Pox.  The  following  is  the  case  as 
reported  by  Ceely  ^  : — 

"On  the  3rd  December,  1865,  Mr.  Henry  Hancock,  veterinary 
inspector,  Uxbridge,  was  engaged  in  superintending  the  autopsy 
of    a    bullock,    recently    dead    of   cattle    plague.      His    assistant, 

'  Notes  of  the  History  of  the  Case  of  Mr.  Henry  Ha)icock, 
Veterinary  Surgeon  and  Inspector,  Uxbridge,  drawn  up  by  Robert 
Ceely,  Esq.     \_Reporf  of  the  Commissioners,  loc  cit,  p.  79.] 


VACCINE  LYMPH r  315 


who  was  performing  the  operation,  while  occupied  in  removing 
the  skin  from  the  scrotum,  accidentally  punctured  the  back  of 
Mr.  Hancock's  hand  with  the  point  of  the  knife.  The  puncture 
being  slight,  was  disregarded  at  the  time,  but  was  washed  as 
soon  as  practicable,  and  thought  of  no  more.  On  the  8th, 
five  days  afterwards,  a  small,  slightly  elevated,  hard  pimple 
was  felt  and  seen  on  the  site  of  the  puncture.  This  gradually 
advanced  till  the  9th  day  of  the  puncture,  the  4th  from 
papulation,  when  the  enlargement  became  distinctly  vesicular. 
At  that  time  there  were  but  slight  constitutional  symptoms. 
On  the  ne.Kt  day,  the  loth  from  the  receipt  of  the  puncture, 
the  5th  from  papulation,  and  the  2nd  from  vesiculation,  he 
called  upon  his  friend  Mr.  Rayner,  of  Uxbridge,  who,  on  seeing 
the  hand,  inquired  if  the  patient  had  been  handling  the  udder 
of  a  cow,  for  that  he  could  recognise  a  Cow  Pock  vesicle  of  the 
9th  day.  The  vesicle  was  then  distended  with  limpid  lymph,  its 
margin  elevated  and  rather  brown,  centre  depressed  and  rather 
brown,  and  was  surrounded  with  a  large  bright  red  areola. 
There  was  then  considerable  tumefaction  extending  from  the 
knuckles  above  the  wrist.  The  absorbent  vessels  were  con- 
siderably inflamed.  They,  and  the  axillary  glands,  were  tender 
and  painful ;  the  pulse,  naturally  slow,  was  accelerated  ;  there 
was  much  pain  in  the  back  and  limbs,  severe  distracting 
headache,  etc.  ;  all  of  which  symptoms  continued  to  increase 
during  the  two  following  days.  At  the  end  of  that  time  the 
diffused  areola  had  extended  as  far  as  the  elbow.  On  the 
1 8th  December,  fifteen  days  after  the  puncture,  and  ten  da3's 
after  papulation,  the  patient  was  seen  in  London  by  Drs.  Klein 
and  Murchison,  and  Professors  Spooner  and  Simmonds.  The 
local  inflammation  and  the  constitutional  symptoms  had  partially 
subsided.  The  vesicle  contained  a  rather  turbid  brownish 
fluid,  and  there  were  present  all  the  indications  of  a  declining 
vaccine  vesicle.  The  above  particulars  were  detailed  to  me 
by  Mr.  Hancock  and  Mr.  Rayner  on  my  visit  to  them  at 
Uxbridge  on  the  20th  December,  and  on  my  exhibiting  the 
different  phases  of  the  vaccine  vesicle  on  the  hand  of  the 
milker  (depicted  in  Plates  III.,  IV.,  and  V.,  in  Further  Observa- 
tions   on    the     Variola;     Vaccina:,    Transactions    of  the    Provincial 


;i6  CATTLE  PLAGUE. 


Medical  and  Surgical  Association,  vol.  x.)/  Mr.  Hancock  im- 
mediately recognised  there  the  exact  correspondence  with 
those  which  occurred  on  his  hand.  On  this  day,  December  20th, 
being  the  l8th  of  the  puncturation  and  the  13th  of  papulation, 
I  observed  manifest  declining  oedema  on  the  back  of  the 
hand,  as  far  as  the  elbow,  with  some  patches  here  and  there 
of  declining  redness  near  it.  The  vesicle,  which  had  been 
many  days  poulticed,  was  depressed  in  the  centre,  puckered  at 
its  margin,  but  still  raised  on  a  palpably  firm  basis.  It 
certainly  exhibited  the  appearances  1  have  often  seen  at  a  corre- 
sponding stage  of  the  loose  vascular  skin  on  the  back  of  the 
hand  of  milkers  aftected  with  casual  Cow  Pox.  A  similar 
vesicle  I  have  depicted  (Plate  V.,  fig.  2)^  in  the  work  above 
referred  to.  The  conclusion  drawn  from  the  appearance  of 
the  vesicle  at  this  time  was  fortified  b}'  a  consideration  of  the 
history  of  its  development.  The  late  appearance  after  the 
puncture,  the  tardy  and  gradual  papulation  and  vesiculation, 
the  period  of  the  advent  of  the  areola,  its  progre^^s,  extent  and 
period  of  decline,  all  corresponding  to  those  phenomena 
resulting  from  the  casual  inoculation  of  the  milker  b}'  the  cow 
affected  with  vaccinia.  I  could  not,  however,  but  regret  that 
lymph  was  not  abstracted  at  the  proper  time  with  a  view  to 
excluding  all  doubt  as  to  its  actual  character." 

Murchison.  in  describing  this  case,  gives  practically 
the  same  account,  with  a  few  additional  details.  The 
appearances,  as  well  as  the  entire  history,  were  very 
different  from  the  results  of  an  ordinary  poisoned 
wound,  but  coincided  with  those  observed  after 
vaccination.  Murchison  observed  that  Mr.  Hancock 
had  been  vaccinated  in  infancy,  and  had  one  good 
vaccination  mark  upon  his  arm.  In  commenting 
further    upon    the    case,     Murchison     pointed    out     that 


'   Vide  Plates  XIII.,  XIV.  -  Plate  XIV.,  fig.  i. 


"  VACCINE  LYMPIir  317 

iherc  was  no  evidence  of  cattle-plague,  or  Cow  Small 
Pox,  being  transmitted  hy  infection  to  man.  l)ut  he 
attributed  this  to  a  difficulty  in  transferring  the  dis- 
ease from  (jne  species  to  another,  and  he  considered 
that  it  was,  therefore,  not  surprising,  on  the  supposi- 
tion that  rinderpest  is  a  form  of  Small  Pox,  that 
human  beings  have  not  suffered  from  it  ;  but  he  adds, 
it  is  not  unreasonable  to  expect  that  inocuhition  of 
human  beings  with  the  virus  of"  rinderpest,  unprotected 
by  vaccination,  or  by  a  previous  attack  of  Small  Pox, 
may,  now  and  then,  produce  results  similar  to  those 
obtained  in  India  by  Messrs.  Macpherson.  Brown,  and 
Furnell,  and  those  recently  observed  in  this  country 
in  the  case  of  j\Ir.  Hancock,  just  as  Small  Pox  in 
man  is  transmitted  with  great  difficulty  back  to  cows. 
Murchison  concluded  by  pointing  out  that  these 
remarks  were  adduced  not  to  prove  the  identity  of 
rinderpest  and  variola,  or  even  that  they  were  patho- 
logical equivalents,  but  to  establish  the  very  close 
analoofv   between   the  two   diseases. 

It  was  not  unnatural  that  Murchison  should  have 
recommended  vaccination  as  a  prophylactic  measure. 
In   a  supplementary   report   we   read  : — 

"  Successful  vaccination  seemed  to  confer  temporary  immunity 
from  the  cattle  plague,  for  in  certain  herds  the  vaccinated  cattle, 
and  they  alone,  escaped  the  disease.  Further  experience,  how- 
ever, has  proved  that  this  immunity,  if  real,  is  very  transient. 
Cattle  that  have  been  successfully  vaccinated,  and  in  which 
the    vaccination    has    run    its    course,    when    brought    in    contact 


3i8  CATTLE  PLAGUE. 


with  animals  suffering  from  cattle  plague,  or  when  inoculated  with 
the  virus  of  cattle  plague,  have  contracted  the  disease  and  died 
of  it.  The  obvious  inference  is,  that  notwithstanding  the  close 
analogy  between  the  cattle  plague  and  human  Small  Pox,  the 
former  disease,  like  the  so-called  Small  Pox  of  sheep,  is  unin- 
fluenced by  ordinar}'  vaccinia,  and,  like  it  therefore,  is  in  all 
probability  a  distinct   species  of  disease  from  human  Small  Pox." 

I  will  now^  pass  on  to  describe  the  consequences  in 
India,  of  Jenner  and  Baron's  teaching  that  tne  terms 
Cow  Pox  and  Cow  vSmall  Pox  are  interchangeable. 

The  cattle  in  Bengal  were  long  subject  to  a  malig- 
nant disease,  which  the  natives  designated  by  the  same 
term  as  human  variola — viz.,  Biissnnt,  Mhata  or  Gotee. 

When  the  medical  men  in  India  heard  that  the 
source  of  vaccine  lymph  was  a  disease  of  cows  with 
an  eruption  on  the  udder,  called  Cow  Small  Pox, 
it  is  not  to  be  wondered  at,  that  in  order  to  raise 
a  stock  of  lymph  they  resorted  to  a  disease  which 
had  pustules  on  the  udder,  and  was  called  Cow  Small 
Pox   by   the   natives   of  India. 

In  1832,  a  series  of  inoculations  was  performed  by 
Mr.  Macpherson  '  in  Bengal.  I  will  give  his  account 
i7t  cxtenso,  from  the  report  which  he  furnished  as 
superintendent    of  vaccination    at    Moorshedabad. 

"  Small  Pox  raged  with  the  most  destructive  virulence  in 
the  city  and  vicinity  during  the  months  of  May,  June,  July, 
and  August  last ;  and  soon  after  receiving  the  Board's  instruc- 
tions, I   made    many   attempts   to   introduce  the  disease   in  cows 


'  Transactions    of  the    Medical  and  Physical.  Society  of  Calcutta, 
p.  i6q.      1883. 


VACCINE  LYMPH.''  319 


by  exposing  them  to  variolous  contagion,  covering  tiieni  with 
the  blankets  of  patients  labouring  under  the  disease,  and  by 
inoculation  ;  but  all  to  no  purpose,  although,  in  these  instances, 
the  animals  had  very  marked  feverish  symptoms,  and  in  one 
those  symptoms  were  followed  by  a  few  small  ulcers  on  the 
abdomen,  from  which  two  cows  were  inoculated  on  the  udder 
and  teats ;  but  no  local  or  constitutional  effects  followed  the 
operation  or   experiment. 

"  Finding  I  could  not  thus  introduce  variola  1  had  two 
young  cows  inoculated  with  vaccine  virus  taken  from  the  arm 
of  a  fine  healthy  child  on  the  eighth  day.  Both  cows  had 
slight  fever,  and  local  inflammation  on  the  third  day.  In  one 
a  vesicle  formed  on  the  fifth  day,  from  which  two  children 
were  inoculated,  and  in  both  instances  the  operation  was  fol- 
lowed by  local  and  slight  constitutional  effects;  but  the  pustules 
were  elevated  and  opaque,  they  had  no  areola,  and  ran  their  course 
in  five  da3's,  evidently  spurious,  consequently  no  attempt  was 
made  to  carry  this  experiment  farther.  On  inquiry  among  the 
natives,  I  learned  that  the  cows  in  Bengal  are  subject  to  a  disease 
which  usually  makes  its  appearance  about  the  latter  end  of  August 
or  early  in  September,  to  which  the  same  names  are  given  as  to 
variola  in  the  human  subject — viz.,  Bussunt,  Mhata  or  Gotee,  and 
on  the  24th  August,  I  was  informed  that  several  cows  belonging  to 
a  native  of  Moidapore  were  affected.  I  consequently  determined 
on  again  attempting  to  regenerate  the  vaccine  virus  from  the 
original  source.  The  animals  which  were  first  affected,  amounting 
in  one  shed  to  eighteen  or  twent}^  had  been,  for  a  day  or  two  pre- 
viously, dull  and  stupid  ;  they  were  always  seized  with  distressing 
cough,  and  much  phlegm  collected  in  the  mouth  and  fauces.  The 
animals  had  apparently  at  this  time  no  inclination  for  food,  or,  at 
all  events,  they  were  unable  to  satisfy  their  hunger.  Their  suffer- 
ings seemed  to  be  greatest  on  the  fifth  and  sixth  days,  when  there 
was  considerable  fever,  and  pustules  made  their  appearance  all 
over  the  body,  especially  on  the  abdomen,  which  terminated  in 
ulceration,  the  hair  falling  off  wherever  a  pustule  had  run  its 
course.  The  mouth  and  fauces  appeared  to  be  the  principal  seat 
of  the  disease,  being  in  some  instances  one  mass  of  ulceration, 
which  in  all  probability  extended  to  the  stomach  and  alimentary 


320  CATILE  PLAGUE. 


canal.  In  those  cases  where  the  mouth  was  very  much  affected 
the  animals  died  apparently  from  inanition;  whereas  those  cases 
in  which  the  power  of  mastication,  or  even  of  swallowing,  was 
retained,  recovered  much  more  rapidly  than  might  have  been 
expected  from  the  previous  severe  sufferings  and  reduced  state  of 
the  animals.  The  mortality  may  be  calculated  at  from  15  to  20 
per  cent.  From  the  above  description  of  the  disease,  the  Board 
will  immediately  observe  that  it  assumes  a  much  more  serious 
complexion  in  this  country  than  we  have  been  taught  to  believe  it 
does  at  home.  I  say  taught,  because  I  presume  it  has  fallen  to 
the  lot  of  few  to  witness  the  disease  in  England  ;  and  it  must  be 
inferred  from  Dr.  Jenner's  and  other  medical  writings  on  the 
subject  that  the  animal  not  only  continued  to  secrete  milk,  but 
that  the  milk  was  used ;  while  in  this  countr}^  the  little  that  is 
secreted  is  never  made  use  of,  and  perhaps  owing  to  this  very  cir- 
cumstance the  Guallahs  or  milkers  in  India  are  not  affected  with 
Cow  Pox,  as  is  the  case  with  this  description  of  persons  in 
Gloucestershire  and  other  counties  in  England  where  the  disease 
is  most  prevalent.  It  is  an  extraordinary  fact,  and  worthy  of 
remark,  that  while  the  cows  were  thus  affected  no  case  of  variola 
amongst  the  natives  in  the  village  presented  itself,  and  although 
the  people  were  ordinarily  averse  from  handling  or  going  much 
amongst  the  cattle  at  the  time  of  disease,  still  they  all  scouted  the 
idea  of  infection,  stating  they  never  heard  of  any  one  contracting 
disease  from  the  cow,  consequently  they  were  under  no  alarm 
on  that  score.  In  consequence  of  the  extreme  jealousy  with  which 
all  my  inquiries  on  this  subject  were  watched  by  the  Hindoos, 
coupled  with  my  own  anxiety  to  conceal  the  object  in  view,  I 
should  have  found  very  great  difficulty  in  prosecuting  my  investi- 
gations had  not  the  disease  assumed  the  character  of  an  epidemic, 
all  the  cattle  in  the  neighbourhood  becoming  affected,  and  amongst 
others  two  belonging  to  one  of  my  own  vaccinators.  I  had  them 
covered  with  blankets,  leaving  merely  the  udder  and  teats  exposed 
to  the  air.  On  the  seventh  day  two  small  pustules  made  their 
appearance  on  the  teats  of  one,  which  dried  up  on  the  tenth,  and 
the  crusts  were  removed  on  the  twelfth  day  ;  from  those  crusts 
eleven  native  children  were  inoculated.  No  effects  whatsoever 
were    produced    or    six   of   this    number.     Two    had    very  slight 


"  VACCINE  lymph:'  321 

inflammation  on  the  arms  on  the  third  and  fifth  days  ;  two  had 
considerable  local  inflammation  and  slight  heat  of  surface  on  the 
fifth,  sixth,  and  seventh  days,  but  no  vesicle  formed,  although 
there  was  marked  induration  round  the  puncture.  The  remaining 
child's  arm  was  slightly  inflamed  on  the  fourth  morning,  and  a 
vesicle  was  apparent  the  next  day,  which  continued  to  increase  till 
the  ninth  day,  when  I  was  much  gratified  to  find  that  it  assumed 
all  the  characteristics  of  true  vaccine.  The  poor  little  child,  the 
subject  of  this  experiment,  was  about  five  months  old,  and  suffered 
much  from  fever  for  four  days,  by  which  he  was  greatly  reduced, 
but  very  soon  recovered. 

"  Two  children  were  vaccinated  from  this  patient  with  the 
most  complete  success,  but  the  symptomatic  fever  was  more 
severe  than  I  have  ever  observed  it  in  former  instances.  Five 
children  were  vaccinated  from  those  just  mentioned,  and  the 
result  was  equally  successful,  after  which  no  difficulty  was 
experienced  in  disseminating  the  disease.  With  the  view,  how- 
ever, of  satisfN'ing  myself  that  true  Cow  Pox  was  introduced, 
I  had  two  children  who  had  been  vaccinated  with  the  fresh 
virus  inoculated  with  Small  Pox,  and  both  were  happily  found 
to  be  secure.  Another  instance  of  the  preservative  powers  of 
the  new  lymph  deserves  mention.  Five  children  in  the  Gorah 
Bazaar  at  Berampore  were  vaccinated,  and  shortly  afterwards  were 
accidentall}^  exposed  to  the  variolous  contagion  by  residing  in  the 
same  huts  where  the  disease  was  raging  very  dreadfully,  but  not 
one  of  those  vaccinated  was  in  the  slightest  degree  affected  by 
variola.  Many  children  belonging  to  His  Majesty's  49th  Regiment 
and  others  in  the  families  of  residents,  both  civil  and  military, 
at  this  station  and  its  vicinity,  had  been  vaccinated  with  the 
regenerated  virus.  My  friend  Dr.  French,  who  invariabl}'  has 
recourse  to  Bryce's  test ;  Mr.  Skipton,  the  superintendent 
surgeon,  and  several  other  medical  men,  have  expressed 
themselves  completely  satisfied  with  the  result.  It  is  a  grati- 
fying fact  that  since  the  introduction  of  the  new  lymph  the 
symptomatic  fever  has  been  more  marked,  and  the  natives  have 
much  greater  confidence  in  the  efficacy  of  the  operation ;  in 
proof  of  which  1  need  merely  mention  that  the  number  pre- 
sented for  vaccination  within  the  last  three  months  has  much 
VOL.  I.  21 


322  CATTLE  PLAGUE. 


exceeded  that  of  any  similar  period  for  the  previous  two  years. 
Variola  has  been  more  or  less  prevalent  in  this  neighbourhood 
for  the  last  seven  months,  and  is  now  committing  dreadful 
ravages  in  several  parts  of  the  city.  Many  instances  are  daily 
presenting  themselves  of  the  disease  attacking  those  who  have 
been  previously  affected,  either  naturally  or  by  inoculation,  and 
I  am  credibly  informed  that  several  of  the  latter  have  fallen 
victims  to  this  dreadful  scourge.  It  is  melancholy  to  reflect 
that  a  city  of  ignorant  and  mercenary  beings,  such  as  the 
Tikadars  in  this  country,  are  permitted  annually  to  regenerate 
the  disease,  and  thereby  keep  up  a  continual  source  of  conta- 
gion, by  which  thousands  of  lives  are  sacrificed.  Accompanying 
I  have  the  pleasure  to  send  some  vaccine  crusts,  and  ivory 
points  armed  with  virus  taken  two  days  since,  from  which,  I 
entertain  no  doubt,  the  disease  will  be  readily  introduced  in 
Calcutta,  and  should  more  be  required  it  shall  be  immediately 
supplied." 

According  to  Dr.  Duncan  Stewart  ^  this  lymph  was 
distributed    throughout    India. 

Mr.  Macpherson's  example  was  followed  by  Mr. 
Furnell,^  in  Assam,  in    1834.      He  wrote  as  follows  : — 

"Being  very  anxious  to  obtain  a  constant  supply  of  vaccine 
virus,  that  which  I  got  from  Decca  at  various  times  having 
been  followed  by  eruptions  all  over  the  body,  and  often  with 
much  fever,  I  was  much  interested  by  the  account  in  the 
Transactions  of  the  Medical  Society  detailing  Mr.  Macpherson's 
success  in  procuring  vaccine  lymph  from  the  original  source, 
the  cow.  I,  therefore,  in  September  last  endeavoured  to  procure 
it  in  the  same  way,  and  having  heard  that  several  cows  in  the 
neighbourhood  of  Silhet  were  affected  with  the  disease  called 
Mhata  or  Gotee,  I  succeeded  in  getting  one  that  was  recovering, 
but  it  had  a  number  of  dried  scabs  over  its  body  ;    from  those 

'  Duncan  Stewart.     Re;p()i-t  on  Small  Pox  in  Calcutta,     p.  146. 

-  7'ransactions  of  the  Medical  and  Pliy steal  Society  of  Calcutta,  p.  453. 


VACCINE  LYMPH."  323 


scabs  I  vaccinated  four  children  without  effect.  My  health 
being  ver}'  bad  at  the  time  I  was  recommended  to  try  Chirra 
for  change  of  air,  and  left  Silhet,  requesting  Mr,  Brown,  who 
kindly  undertook  my  duty,  to  follow  up  the  trial,  at  the  same 
time  offering  a  reward  to  any  person  who  would  bring  a  cow 
having  the  disease.  Ere  I  returned  to  Silhet,  Mr.  Brown  vacci- 
nated several  children,  the  first  four,  direct  from  the  cow,  and 
afterwards  continued  vaccinating  from  these  children  in  succes- 
sion. In  the  first  four,  the  vaccine  vesicle  appeared  most 
favourable  on  the  eighth  day,  and  in  those  who  were  vaccinated 
from  them,  the  disease  also  appeared  well  marked  on  the 
eighth  day.  On  my  return,  I  found  all  in  a  fair  train,  as  I 
thought,  and  continued  vaccinating  until  the  middle  of  Novem- 
ber, when  I  was  again  obliged  to  go  to  Chirra  for  the  benefit 
of  my  health.  During  my  absence,  Mr.  Brown  vaccinated  Major 
Orchard's  child  on  the  23rd  of  that  month.  On  my  return  on 
the  30th,  I  found  that  the  vesicle  did  not  appear  in  so  forward 
a  state  as  it  should  have  been,  but  from  its  appearance,  I 
thought  that  it  had  only  been  retarded  in  its  progress,  as  at 
the  time  the  babe  was  vaccinated  she  had  a  slight  teething 
rash.  On  the  ist  December,  it  looked  much  better,  and  on  the 
evening  of  that  day,  the  eighth  of  the  vaccination,  she  had 
slight  fever,  and  got  in  the  evening  a  grain  of  calomel,  and  in 
the  morning  following,  some  castor  oil,  which  affected  her  bowels 
slightly.  On  the  evening  of  the  second,  the  dose  of  calomel 
was  repeated,  and  followed  by  oil  next  morning ;  the  fever 
continued  but  slight.  On  the  3rd  day,  from  the  commencement 
of  the  fever,  an  eruption  similar  to  that  preceding  Small  Pox 
appeared,  and  in  four  days  from  that,  she  was  completely 
covered  with  an  eruption  resembling  the  Small  Pox  at  its 
confluent  point,  which  ran  through  the  same  course  as  natural 
Small  Pox,  She  was  quite  well  on  the  i8th  December,  with 
a  few  pocky  scabs  scaling  oft'.  Before  the  above-mentioned 
eruption  made  its  appearance  three  native  children  that  were 
vaccinated  on  the  same  day  as  Mrs.  Orchard's  child,  and  from 
the  same  source,  were  brought  to  me,  and  the  vesicles  having 
a  most  favourable  appearance,  I  vaccinated  my  own  baby  from 
one  of  them.      On  the    1st  December,   being   much    alarmed  on 


324  CATTLE  PLAGUE. 


seeing  the  eruption  on  Mrs.  Orchard's  little  girl,  I  sent  for  the 
boy  from  whom  she  was  vaccinated,  and  found  that  he  had, 
had  very  little  fever,  but  he  had  a  few  scabs,  about  twenty 
on  his  entire  body.  I  also  had  the  three  children,  who  were 
brought  to  me  on  the  day  my  little  one  was  vaccinated,  with  me 
daily  ;  none  of  them  had  fever  for  m.ore  than  one  day  ;  in  two 
of  them  a  slight  eruption,  and  on  the  third  child  there  was  not 
an  eruption  of  an}^  kind,  and  the  vaccine  vesicle  in  all  of  them 
went  through  its  regular  course.  Notwitstanding  this  I  took 
every  precaution,  and  on  the  eighth  day  of  vaccination,  slight 
fever  having  come  on,  my  little  one  had  a  little  calomel  and 
on  the  following  morning  some  oil ;  yet  the  fever  increased, 
and  the  dose  was  repeated  on  the  following  evening  and  the 
oil  next  morning  with  the  desired  effect.  On  the  third  day  of 
the  fever,  a  very  thick  eruption  appeared  on  the  face,  and 
followed  the  course  of  Small  Pox  in  its  worst  form.  On  the 
seventh  day,  from  the  commencement  of  the  eruption  her 
mouth  and  throat  became  so  sore  that  she  was  unable  to  take 
the  breast  or  any  other  food :  it  was  very  necessary  to  try 
to  support  her  by  a  nourishing  injection,  notwithstanding  which 
she  sank  on  the  20th.  The  above  report,  it  is  hardly  necessary 
to  say,  is  given  with  great  pain  ;  but  I  feel  that  it  is  right  to 
do  it,  and  to  warn  my  brethren  of  the  danger  that  sometimes 
occurs  after  taking  the  virus  from  the  cow  in  this  climate. 
Mhata  in  the  cow  of  this  country  is  decidedly  a  much  more 
serious  disease  than  the  vaccine  diseases  in  the  animal  in 
Europe.  And  it  will  be  seen  from  the  above  statement  that 
the  inoculation  from  it  is,  in  the  human  subject,  followed  by  a 
most  dreadful  disease,  but  I  will  refrain  from  further  remarks  ; 
but  I  think  it  is  necessary  to  state  that  such  precautions  were 
taken  in  this  trial  that  it  was  almost  impossible  that  any 
admixture  of  the  variolous  disease  could  have  been  made,  as 
all  the  children  mentioned  were  vaccinated  direct  from  the  cow.^ 
Two  native  vaccinators  were  deputed  to  vaccinate  at  the 
houses    of   the    natives,    and    the    third,    in    whom    I    had    great 

'  "  The  first  four  from  the  cow  ;  in  the  remainder  the  lymph  was  pro- 
pagated from  the  first  four  children  by  Mr.  Brown  or  myself." 


VACCINE  LYMPHr 


325 


confidence,  was  employed  about  the  station,  and  brought  weekly 
three  or  four  healthy  subjects  to  be  vaccinated  from  those 
vaccinated  by  myself  or  Mr.  Brown.  Neither  should  we  have 
known  that  the  vaccination  had  been  followed  by  any  serious 
result  had  it  not  been  for  the  above  melancholy  case,  as^  on 
the  strictest  inquiry,  I  cannot  learn  that  any  of  the  native 
children  vaccinated,  suffered  from  illness,  not  one  having  got 
any  medicine  ;  not  the  slightest  pitting  followed  in  either,  as  the 
eruption  left  no  pits  on  Major  Orchard's  child.  I  have  been 
so  ill  since  the  22nd  of  last  month  that  I  have  been  obliged 
to  leave  Silhet,  or  I  should  have  given  this  report  earlier.  I 
have  within  a  few  days  learned  that  Captain  Fisher's  suffered 
also  from  a  severe  eruptive  fever  after  vaccination  from  virus 
sent  from   Silhet. 

"  In  answer  to  your  question  I  mentioned  yesterday  that  I  had 
heard  from  Silhet  that  young  Mr.  Tereneau  was  suffering  under 
an  affection  of  the  kind. 

"  I  give  you  the  words  of  my  correspondent.  '  In  my  letter 
yesterday  I  mentioned  that  young  Tereneau  had  an  eruption 
which  I  took  for  one  of  the  patches  of  roseola.  To-day,  however, 
it  has  singularly  enough  been  assuming  the  identical  appearance 
which  came  out  on  your  baby.'  He  was  twice  vaccinated,  first 
in  India,  and  afterwards  in  Scotland,  and  all  right.  I  can  only 
suppose  that  he  caught  the  infection  from  Mrs.  Fisher's  child.  I 
heard  of  several  cases  of  Small  Pox  in  Silhet  about  the  time  my 
little  one  was  vaccinated.  The  native  vaccinator,  designated  the 
third  in  the  report,  was  taken  ill  about  the  24th  of  December. 
His  case  was  mentioned  as  a  case  of  Small  Pox ;  however,  if  it 
was,  it  was  a  ver}'  slight  eruption.  He  did  not  keep  his  bed  after 
it  appeared.     He  was  inoculated  when  a  child." 

According  to  Dr.  Duncan  Stewart,  Mr.  Brown  made 
use  of  the  scabs  taken  from  the  back  or  abdomen 
of  the  diseased  cattle.  These  were  reduced  to  a  pulp 
with  water,  and  employed  for  inoculating  the  four 
children   mentioned  above. 


326  CATTLE  PLAGUE. 


" '  In  all  four,  vesicles  in  every  respect  resembling  in  their 
progress  and  when  mature  genuine  vaccinia,  made  their  appear- 
ance, and  went  the  same  regular  course,  the  constitutional 
disturbance  on  the  eighth  day  only  being  more  severe  than  I 
have  usually  seen  it  in  the  latter.^'" 

"  From  these  many  other  native  children  were  inoculated,  and 
no  doubts  of  the  genuineness  of  the  lymph  were  excited  until 
two  English  children  were  punctured  from  one  of  them,  and  it 
was  then  found  that  Small  Pox  supervened  in  both  of  these 
cases,  and  this  was  more  than  suspected  to  have  happened  in 
many  of  the  native  children,  who  had  generally  dispersed  a  few 
days  after  the  operation,  and  were  not  afterwards  heard  of.  One 
of  the   English  children  unhappily  died."- 

According  to  Baron,  in  1837,  another  series  of  inocu- 
lations was  performed  by  Mr.  Macpherson  in  Bengal 
with  virus  from  diseased  cows,  "  on  which  occasion  an 
eruptive  complaint  of  the  true  variolous  nature  was 
produced ; "  and  similar  phenomena  were  observed  at 
Gowalpara  by  Mr.  Wood  in   1838. 

"  In  several  of  his  cases  the  symptoms  were  so  severe  as  to 
excite  apprehension  that  the  disease  would  terminate  fatally.  He 
was  so  strongly  impressed  with  this  fact,  that  he  thought  it  would 
be  better  to  take  human  Small  Pox  rather  than  Cow  Small  Pox 
for  inoculation,  when  the  latter  assumes  its  dangerous  and  fatal 
form." 

From  all  these  independent  observations,  if  we 
accept  them  as  correct,  there  would  seem  to  be  no 
doubt  that  cattle-plague  virus  inoculated  in  the  human 
subject  will  produce  a  vesicle  with  the  physical  characters 

■  Quarterly  Journal,  Calcutta  Medical  Society,  April  1837 
2  Report  on  Small  Fox  in  Calcutta,  p.  148,  by  Duncan  Stewart,  M.D. 
1844. 


''VACCINE  lymph:'  327 


of  the  vaccine  vesicle,  and  succeeded  occasionally  by  an 
eruption  which  appears  to  have  the  characters  of  the 
eruption  of  cattle-plague.  That  cattle-plague  is  not 
infectious  to  man  in  the  ordinary  sense  affords  no 
proof  that  the  disease  may  not  be  cultivated  in  the 
human  subject  by  inoculation. 

But  these  occurrences  had  to  be  explained  away,  for 
such  circumstances  were  incompatible  with  the  Small 
Pox  theory  of  Cow  Pox.  We  have  only  to  turn 
again  to  Dr.  Seaton's  Handbook  of  Vaccination  to 
find  that  ingenious  explanations  were  forthcoming. 

First  of  all,  with  regard  to  Dr.  Macpherson's  cases, 
Seaton  admitted  that  the  "  vaccinations  "  were  genuine, 
and  that  a  stock  of  "  vaccine "  was  established  and 
was  afterwards  regularly  continued.      But  he  adds  : — 

"  From  these  facts  it  is  not  to  be  doubted  that  a  case  of  Cow 
Pox  in  the  cow  had  been  met  with  ;  but  what  is  to  be  doubted  is 
that  the  Gotee — the  mahgnant  disease  above  referred  to — was  the 
source  of  this  infection." 

It  was  evidently  impossible  for  Seaton  to  admit 
that  a  vaccine  vesicle  could  be  produced  by  "  manage- 
ment "  of  cattle-plague.  But  having  admitted  that  a 
vaccine  vesicle  had  somehow  resulted,  the  only  way  out 
of  the  difficulty  was  to  suppose  that  in  some  extra- 
ordinary way  a  case  of  Cow  Pox  had  cropped  up 
amidst  the  epidemic  of  catde-plague.  Nor  does  the 
fact  that  these  experiments  were  repeated  by  Furnell 
in  another    part  of   India,   appear   in   the   least   to   have 


328  CATTLE  PLAGUE. 


shaken  his  opinion.  But  while  Seaton  throws  doubt 
upon  the  Gotee  as  the  source  of  the  lymph,  he 
admits  that  the  cows  had  "a  generalised  eruption  of 
some  kind  or  another,"  and  he  explains  the  pustular 
eruption  in  the  inoculated  children  as  the  result  of 
an  accidental  admixture  of  either  inoculated  or  casual 
human  Small  Pox.  If  we  are  to  accept  Seaton's 
view,  we  must,  in  some  similar  fashion,  explain 
away  the  independent  experience  of  Mr.  Wood,  of 
Gowalpara,  and  reject  Ceely's  and  Murchison's 
accounts  of  inoculated  cattle-plague  on  the  hand  of 
Mr.    Hancock. 


CHAPTER  XI. 

SHEEP  SMALL   POX  AS  A    SOURCE   OF   "  VACCINE 
LYMPH r 

Sheep  Pox,  or  variola  ovina,  is  a  common  disease 
in  some  parts  of  Europe.  In  France,  the  disease 
is  called  la  claveUe,  and  in  Italy,  vaccuolo.  It  has 
been  introduced  on  several  occasions  into  this  country, 
but  has  been  effectually  stamped  out.  As  in  human 
Small  Pox,  there  are  varieties ;  the  benign  and  the 
malignant ;  the  discrete  and  the  confluent.  It  is  an 
acute  febrile  disease  accompanied  by  a  general  vesiculo- 
pustular  eruption,  highly  infectious,  and  capable  of 
being  propagated  by  inoculation  or  clavelisation. 

It  is  very  closely  analogous  to  human  Small  Pox, 
and  as  another  result  of  the  misleading  theory  of 
Cow  Pox  being  Cow  Sinall  Pox,  not  only  was  vacci- 
nation employed  to  protect  sheep  from  Sheep  Pox, 
but  "  vaccine  lymph "  was  raised  from  Sheep  Pox  to 
protect  human  beings  from  Small  Pox.  These  experi- 
ments were  first  performed  in  Italy,  and  have  been 
described  in   detail   by   Sacco.^ 

"  In    1802,    Dr.    Marchelli     communicated     to    the    Socicta    di 
'  Sacco.     Trattato  di  Vaccinazione.     p.  144.     1809. 


330  SHEEP  SMALL  POX. 

Emulazione  of  Genoa,  to  which  I  have  also  the  honour  to  belong, 
the  fact,  that  Small  Pox  of  sheep  might  be  substituted  for  Cow 
Pox ;  but  as  he  had  then  made  only  a  very  few  experiments, 
with  a  view  of  ascertaining  if  it  were  efficacious  or  harmful  when 
transmitted  to  man,  he  undertook  to  continue  his  researches, 
and  then  to  publish  the  results.  However,  as  he  has  recently 
informed  me,  he  has  not  been  able  to  do  so  in  consequence  of 
a  long  and  severe  illness  from  which  he  has  been  suffering  ;  it 
is  this  which  has  retarded  the  publication  of  these  valuable 
observations  which  would  have  led  to  important  results,  and 
would  have  thrown  light  on  this  branch  of  science. 

'•'  Since  I  published  my  practical  observations,  I  have  suggested 
the  vaccination  of  sheep  in  order  to  protect  them  from  the  malady 
to  which  they  are  subject.  I  had  indeed  vaccinated  more  than 
seventy ;  but  never  having  had  the  opportunity  of  seeing  the 
Small  Pox  of  these  animals  in  our  midst,  I  have  not  been  able, 
for  many  years  past,  to  ascertain  whether  by  means  of  this 
inoculation  they  have  been  really  protected.  During  the  many 
journeys  which  1  made  with  a  view  to  extending  vaccination  in 
the  kingdom,  1  redoubled  my  efforts  in  vain  ;  I  only  succeeded 
in  meeting  with  it  in  the  State  of  Naples,  at  Capua.  Passing 
through  it  in  1804,  I  saw  a  peasant  who  was  driving  a  flock  of 
seven  sheep  to  the  butcher's  ;  as  I  was  obliged  to  stop  in  this 
town,  I  endeavoured  to  profit  by  the  opportunity  and  to  gain 
information  on  the  subject. 

"  Having  noticed  the  miserable  and  dejected  appearance  of 
these  sheep  I  stopped ;  and  after  putting  various  questions  to 
the  peasant,  and  examining  the  nature  and  character  of  the 
eruption  and  of  the  symptoms  which  accompanied  it,  I  felt  sure 
that  the  malady  was  the  true  Small  Pox  of  sheep.  The  peasant 
told  me  that  the  malady  was  common  in  the  neighbourhood, 
that  fifty-four  sheep  had  already  been  slaughtered,  and  that 
they  would  continue  this  method  if  the  malady  should  develop 
in  others,  because  treatment,  besides  being  costly  and  difficult, 
was  often  useless,  and  exposed  the  rest  of  the  flock  to  the  con- 
tagion of  the  illness.  I,  with  great  care,  collected  matter  from 
the  finest  vesicles,  in  small  tubes,  with  the  intention  of  testing  it 
at  the  first  opportunity. 


' '  VA  CCINE  L  YAIPH.  "  33 1 

"  On  returning  to  m}^  own  province  on  Christmas  Day  of  the 
same  year,  I  went  as  soon  as  I  had  reached  La  Cattolica,  wliich 
was  then  the  last  place  on  the  frontier  of  the  kingdom  of  Italy, 
in  search  of  Dr.  Legni.  I  informed  him  of  my  design,  and 
my  desire  to  make  experiments  with  the  matter  obtained  from  the 
sheep,  at  Capua  ;  he  kindly  seconded  my  project.  He  procured 
me  six  children,  who  were  all  inoculated  with  the  matter,  which 
was  still  fluid  ;  1  also  inoculated  two  other  infants  with  true 
vaccine,  in  order  to  institute  a  comparison.  I  then  left  the 
neighbourhood,  entrusting  the  examination  of  the  inoculated 
children  to  the  above-named  physician,  who  was  to  inform  me 
of  the  results.  A  month  later  he  sent  me  an  exact  account  of 
all  he  had  observed,  the  substance  of  which  was,  that  the  in- 
oculations advanced  at  the  different  stages  in  the  way  which 
is  usual  with  the  vesicles  of  Cow  Pox,  and  that  he  had  failed 
to  see  any  appreciable  difterence.  He  continued  to  vaccinate 
with  the  same  matter  for  several  years,  and  always  with  the 
same  success.^ 

"  I  had  no  sooner  arrived  at  Milan  than  I  put  to  the  test 
the  remains  of  the  matter  which  I  had  brought  with  me.  I  at 
once  inoculated  four  infants  with  it,  but  was  greatly  surprised 
to  find  that  it  produced  no  effect  upon  them  ;  for  want  of  fresh 
virus  from  the  sheep  I  was  then  obliged  to  suspend  further 
experiments. 

'•'In    the    month    of  October,    1806,    I    visited    the  Apennines 


'  Extract  from  the  letter  of  Dr.  Mauro  Legni,  of  June  29th,  1808  : — 
"  Having  pointed  out  its  characters,  I  will  now  endeavour  to  sum  up 
all  that  I  have  already  written  on  the  Small  Pox  of  sheep;  it  has  sub- 
stantially a  course  in  every  way  analogous  to  Cow  Pox  ;  although  the 
vesicles  produced  by  the  first  insertions  of  the  original  matter  appear  to 
have  had  but  little  vigour;  they  were  otherwise  well  formed.  I  have 
used  this  matter  for  two  years,  and  I  have  inoculated  more  than  three 
hundred  infants  with  it,  of  whom  one  hundred  were  at  Pesaro,  where 
Small  Pox  has  since  reigned  for  three  consecutive  years  ;  and  where,  in 
spite  of  such  a  prolonged  and  fatal  epidemic,  all  those  inoculated  with 
the  sheep  virus  have  been  preserved  from  this  fatal  distemper,  although 
they  were  in  very  close  communication  with  those  who  were  attacked 
by  Small  Pox." 


SHEEP  SMALL  POX. 


with  the  object  of  helping  the  different  districts  by  rendering  the 
practice  of  vaccination  general,  and  I  then  found  means  of 
verifying  my  theory.  In  many  places  I  had  the  opportunity  of 
observing  this  epidemic  disease  of  sheep  and  of  following  it 
in  all  its  stages. 

"  I  recommenced  my  researches  in  the  neighbourhood  of 
Montemiscoso,  by  inoculating  the  same  malady  in  other  sheep, 
and  I  ascertained  that  its  course  was  only  a  little  milder 
and  more  rapid,  and  that  it  acted  precisely  in  the  same 
way  as  inoculated  Small  Pox  does  in  man.  But,  as  this 
inoculation,  although  producing  a  milder  disease,  was  still  ac- 
companied by  the  inconvenience  of  spreading  the  contagion 
and  further  diffusing  it  in  the  flock,  I  determined  to  vaccinate 
several  sheep,  with  the  object  also  of  trying  upon  them  the 
subsequent  effects  of  Sheep  Pox.  The  vaccination  ran  its 
proper  course,  and  the  experiment  was  successful,  for  the  Sheep 
Pox  no  longer  appeared,  although  the  sheep  associated  with 
others  which  were  infected.  I  had,  therefore,  assured  myself 
by  this  experiment,  that  vaccination  had  rendered  these  sheep 
insusceptible  of  a  similar  malady. 

"  As  the  ovine  virus,  inoculated  in  sheep,  gave  rise  to  a 
disease  with  symptoms  which  were  regular,  constant,  and  benign, 
I  was  induced  to  inoculate  three  infants  with  vims  taken  from 
a  lamb  which  did  not  appear  to  be  very  ill  :  two  others  were 
inoculated  in  one  arm  with  the  ovine  virus,  and  in  the  other 
with  vaccine.  I  had  on  this  occasion  the  satisfaction  of  seeing 
that  all  that  Dr.  Legni  had  written  to  me,  from  La  Cattolica 
some  years  before,  of  the  results  of  the  inoculation  which  I 
had  made  with  Sheep  Pox,  whilst  passing  through  that  place, 
was  fully  confirmed.  Of  the  first  three  children  inoculated 
with  the  sheep  virus,  two  had  one  vesicle  each  ;  of  the  second 
children,  one  had  only  one  vesicle  on  each  arm,  and  the  other 
had  two,  but  only  of  the  Cow  Pox.  The  vesicles  which  had 
developed  were  so  similar,  that  if  I  had  not  made  a  mark  to 
remind  myself  on  which  arms  I  had  inoculated  the  Cow  Pox, 
and  on  which  the  Sheep  Pox,  I  could  not  have  distinguished 
one  from  the  other.  A  few  days  after  desiccation  I  inoculated 
with  human  Small  Pox,  the  two  children  in  whom  the  virus  of  the 


VA  CCINE  L  YMPH. ' '  7,11 


sheep  had  been  completely  successful,  but  no  effects,  either 
general  or  local,  resulted. 

"Continuing  my  journey  by  Fosdinovo  and  AuUa,  I  had  the 
opportunity  of  seeing  the  same  sheep  disease  in  various  places, 
and  of  continuing  my  observations. 

"  I  inoculated  several  persons  at  Fosdinovo,  amongst  others 
the  sons  of  Cancelliere  Uccelli ;  others  were  made  in  Barbarasco 
near  Aulla,  where  I  also  inoculated  a  cow  with  the  same 
matter.  I  observed  the  course  of  those  made  at  Fosdinovo, 
and  in  all,  the  ordinary  vesicle  was  similar  to  that  of  Cow  Pox. 
I  left  the  Barbarasco  cases  to  be  observed  by  Dr.  Magnani, 
an  accomplished  surgeon  at  Aulla,  who  sent  me,  eventually,  an 
exact  account  of  them.^ 

"  Proceeding  to  Lucca,  I  used  the  same  virus  to  inoculate 
various  people,  and  continued  to  vaccinate  also  in  other  places, 
always  renewing  the  matter  which  had  been  originally  taken  from 


'  Account  sent  by  Doctor  Antonio  Magnani  of  Aulla,  to  Professor 
Luigi  Sacco,  Director-General  of  Vaccination,  at  the  request  of  the 
latter  conveyed  in  a  memorandum  of  December  9th,   1806  : — 

"  I.  On  8th  and  nth  of  the  month,  I  went  to  Barbarasco  to  see  the 
four  children  whom  you  had  inoculated  with  virus  from  the  sheep,  and 
designated  in  your  list  as  Nos.  13,  14,  15,  and  16,  I  saw  only  two  of 
them,  who  had  contracted  the  malady,  namel}^  the  brothers  Gioacchino 
and  Domenico  Biondi  ;  the  former  had  two  very  beautiful  vesicles  on 
each  arm,  and  the  latter  had  only  a  single  one  on  the  right  arm.  After 
a  very  careful  examination,  I  found  that  the  vesicles  on  both  boys  were 
like  those  of  true  Cow  Pox,  surrounded  b)^  a  red  circle  ;  I  further  observed 
that  the  matter  in  both  cases  was  different  to  that  of  true  Cow  Pox, 
that  is  to  say  that  on  the  eighth  day  it  was  of  a  yellowish  colour ;  and 
on  this  same  day  I  noticed,  moreover,  that  the  vesicles  already  began 
to  form  a  crust,   and  this  was  of  a  colour  which  tended  to  yellow. 

"  2.  On  my  first  visit  to  these  boys  I  took  the  virus  from  their  vesicles, 
and  found  it  to  be  serous,  of  a  yellowish  colour,  and  not  at  all  limpid. 
With  this  matter  I  inoculated  two  other  persons  ;  in  both  cases  two 
vesicles  on  each  arm  appeared  on  the  seventh  day,  filled  with  limpid 
matter,  and  I  afterwards  obser\'ed  that  these  vesicles  ran  their  course 
in  the  same  manner  as  those  of  vaccinated  persons. 

"3.  However,  the  matter  from  these  vesicles  having  been  taken  on  the 
seventh  day,  I  wished  to  inoculate  three  more  persons  in  the  commune 
of  Tendola  ;    I  found  on  visiting  them   on  the  eighth  day,  that  they  all 


334  SHEEP  SMALL  POX. 

Sheep   Pox,  its  course  being  always  very  regular,  and  its  effect 
constant,  as  if  it  had  been  derived  from  a  genuine  Cow  Pox." 

In  more  recent  times,  extensive  experiments  were 
carried  out  in  England  to  test  the  protective  pov^er 
of  vaccination  against  Sheep  Pox.  According  to 
Marson  and  Simmonds,  it  was  very  difficult  to  get 
Cow  Pox  to  take  on  sheep,  and  when  an  effect  was 
produced,  the  resulting  affection,  even  when  developed 
to  its  fullest  extent,  was  very  unlike  the  same  disease 
in  the  human  subject.  In  the  sheep,  it  seldom 
produced  anything  more  than  a  small  papule,  which 
occasionally  resulted  in  the  formation  of  a  minute 
vesicle,  or  more  commonly,  a  pustule,  which  was 
sometimes,  although  very  rarely,  surrounded  by  a 
slight  areola.  Generally,  however,  neither  vesication 
nor  pustulation  followed  ;  but  a  small  scab  was  pro- 
duced, which  soon  fell  from  the  site  of  the  puncture, 
leaving  no  trace  behind.     The    disease  passed    quickly, 


had   two   vesicles    on     each    arm  ;    and   I    remarked    besides    that    the 
humour  which  they  contained  was  limpid  and  crystalline. 

"  4.  On  inspection  of  the  cow  which  you  inoculated  at  several  points 
with  the  same  matter,  I  found  on  the  udder  a  single  vesicle,  from  which 
I  took  matter,  which  was  yellowish  in  colour  and  not  limpid,  and 
used  it  to  inoculate  two  other  boys  ;  the  first  had  two  vesicles  on  each 
arm,  and  on  the  second  I  found  only  one,  on  the  left  arm  ;  in  other 
respects  the  virus  contained  in  the  two  vesicles  was  exactly  similar  to 
that  of  true  Cow  Pox.  I  have  vaccinated  with  this  matter  other 
persons,  and  from  these  again  I  inoculated  others,  whom  I  visited 
soon  alter,  hoping  that  they  would  succeed  equally  well ;  the  result 
was,  and  still  is,  most  successful. 

"AuLLA,  January  zqth,   1807." 


VACCINE  LYMPH.''  335 


and  irregularly  through  its  several  stages,  and  termi- 
nated by  the  eighth  or  ninth  day,  and  not  unfrequently 
even  betore  that  time.  Lymph  was  but  rarely  obtain- 
able, and  then  only  in  the  smallest  quantity,  and  this 
on  the  fifth  or  sixth  day  succeeding  the  vaccination. 
The  effects  were  only  local,  and  the  animal's  health 
was   not  impaired. 

Sheep  were  found  to  be  just  as  susceptible  of  the 
Cow  Pox  virus  on  subsequent  repetition  of  the  inocu- 
lation as  they  were  in  the  first  instance,  and  hence 
the  conclusion  that  Cow  Pox  was  utterly  worthless  as 
a  protective    against    Sheep    Pox. 

According  to  Depaul,  however.  Cow  Pox  takes 
characteristically  on  sheep,  and  Sheep  Pox  lymph 
inoculated  on  cows  produces  a  perfect  "  vaccine." 
It  is  impossible  to  say  whether  these  conflicting  results 
depended  upon  the  employment  in  the  experiments 
of  different  breeds  of  sheep,  or  different  stocks  of 
vaccine    lymph. 

But  the  experiments  of  Marson  and  Simmonds, 
which  have  just  been  referred  to,  were  not  the  only 
ones  made  in  this  country.  Marson  succeeded  in 
raising  on  the  Jiuman  subject,  a  vesicle  with  the 
physical  characters  of  the  vaccine  vesicle,  and  thus 
confirmed    Sacco's    "  vaccinations." 

"  When  Small  Pox  appeared  in  this  country  in  the  sheep  in 
1847,  we  tried  to  communicate  it,  by  inoculation,  to  the  human 
subject,   and    thought    we    had    succeeded    in    doing  so,   and  the 


336  SHEEP  SMALL  POX. 

virus  was  carried  on  from  one  to  another  for  several  weeks  in 
succession.  The  pock  produced  was  very  like  Cow  Pox,  having 
only,  as  we  thought,  a  bluer  tinge,  and  was  protective  against 
Small  Pox,  as  we  ascertained  by  inoculating  the  patient  afterwards 
with  the  lymph  of  human  variola ;  but  we  had  unfortunately 
used  for  the  original  ovination  the  same  lancet  instead  of  having 
a  new  one,  as  we  ought  to  have  had,  that  we  had  previously 
used  for  vaccinating ;  and  although  it  was,  as  we  believe,  perfectly 
clean  and  free  from  vaccine  lymph,  nevertheless,  as  the  disease 
could  not  be  produced  again  in  the  human  subject,  either  by 
Mr.  Ceely  of  Aylesbury,  who  made  repeated  trials  with  the 
lymph  of  Sheep  Pox,  or  by  ourselves,  the  experiment  was  never 
brought  before  the  profession." 

The  failures  in  subsequent  attempts  do  not  invali- 
date the  successful  experiment,  just  as  the  numerous 
failures  to  raise  a  "  vaccine  vesicle  "  by  variolation  of 
cows,  in  no  way  disprove  the  results  of  more  fortunate 
experimenters.  In  both  cases,  the  effects  depend  upon 
the  nature  and  "  management  "  of  the  lymph. 


CHAPTER    XII. 

GOAT  POX  AS  A    SOURCE   OF   "  VACCINE  LYMPHr 

Goats    are    subject    to    an    eruptive    disease,    which    is 
alleged  to  be  similar  to  Small  Pox  in  man. 

Dr.  Valentine  and  others  proved  that  it  was  pos- 
sible to  vaccinate  the  goat  and  to  retro-vaccinate  the 
human  subject  ;  and  Professor  Heydeck,  at  Madrid, 
meeting  with  an  outbreak  of  an  eruptive  disease  of 
goats  known  as  Goat  Small  Pox,  and  influenced,  no 
doubt,  by  the  doctrine  that  vaccine  lymph  was 
derived  from  Cow  Sinall  Pox,  proposed  to  employ 
the  lymph  from  this  source  to  afford  human  beings 
protection  from  Small  Pox.  A  friend  of  Mr.  Dunning 
received  the  following  letter  brietiv  referring  to  these 
experiments  '} — 

"  Madrid,  March  gth,  1 804. 
"  I  am  not  able  to  send  you,  at  present,  our  observation  on  the 
Goat  Pock  subsequent  to  the  8th  of  June  last,  because  it  is  not 
finished  yet ;  for  the  king  ordered  in  September  last  that  all 
the  children  in  the  Foundling-house,  and  those  who  are  in  the 
Desam parados  should  be  inoculated  with  the  Goat  Pock,  which  did 
its  effects ;  we  are  now  employed  in  the  contra-proofs,  and  after 
everything  is  finished,  shall  send  the  whole  process  to  you  for  the 

'  Baron,  Inc.  cit. 
VOL.    J.  2  2 


338  GOAT  SMALL  POX. 

inspection  of  your  medical  friends  and  Dr.  Jenner ;  and  as  I  am 
at  present  on  another  discovery,  not  less  useful  than  the  Goat  Pock, 
I  shall  give  also  an  account  of  its  results  in  my  next  letter." 

His  friend  replied: — 

"  I  wrote  to  the  Professor  about  three  weeks  ago,  told  him  that 
his  discovery  had  excited  very  much  the  attention  of  the  medical 
world  in  England,  and  more  immediately  Dr.  Jenner's,  and  urged 
him  to  forward  his  further  observations  with  all  the  expedition  in 
his  power,  and  that  I  would  transmit  them  to  you." 

Mr.  Dunning  published  an  account  of  these  experi- 
ments, but  Jenner  discountenanced  the  idea.  In  a 
letter  to   Mr.   Dunning,  he  wrote  : — 

"  I  believe  we  have  had  no  correspondence  since  your  Spanish 
paper  appeared  in  the  Medical  and  Philosophical  Journal.  To  be 
plain  with  you,  and  use  the  familiarity  of  a  friend,  I  do  not  like  it. 
The  paper  is  not  now  before  me  ;  but  if  I  recollect  right,  it  went 
only  to  prove  that  goats  are  subject  to  spontaneous  pustules  upon 
their  nipples  ;  that  the  matter  of  these  pustules  was  inserted  into 
the  arms  of  human  subjects ;  and  that  it  produced  local  effects.  Is 
there  any  quadruped  that  is  not  subject  to  diseased  nipples?  Even 
the  human  animal,  we  know  from  sad  experience,  is  not  exempted. 
The  cow,  like  other  animals,  is  subject  to  a  spontaneous  pock  upon 
its  teats,  the  fluid  of  which,  when  brought  in  contact  with  the 
denuded  living  fibre,  is  capable  of  exciting  disease  ;  but  I  posi- 
tively assert,  this  is  not  one  grand  preventive.  When  you  hear 
again  from  Madrid,  do  not  fail  to  tell  me  what  the  Spaniards  say 
about  it.     I  have  already  anticipated."  . 

And   in   a  postscript   he  added  : — 

"  Do  not  fail  to  write  soon.  I  want  to  know  your  further  senti- 
ments of  the  Goat  Pox." 

I    have    not    been    able    to    ascertain    whether    any 


VACCINE  LYMPH."  339 


further  experiments  were  made  at  the  time,  or  what 
became  of  the  stock  of  goat  lymph  "  which  ditl  its 
effects."  Nor  have  I  been  able  to  obtain  the  history 
of  similar  experiments  with  any  diseases  of  the  goat, 
in  more  recent  times. 


CHAPTER    XIII. 

CO  TV  POX  AS  A    SOURCE   OF  "  VACCINE  LYMPH.  " 

The  description  given  by  Jenner  in  the  Inquiry,  was 
the  first  published  account  of  Cow  Pox.  He  described 
the  disease  in  the  cow  as  consisting  of  irregular  pus- 
tules on  the  teats,  of  a  palish  blue  colour,  surrounded 
by  an  erysipelatous  inflammation,  and  characterised 
by  a  tendency  to  degenerate  into  phagedenic  ulcers. 
The  animals  were  indisposed,  and  the  secretion  of 
milk  lessened. 

This  description  is  not  so  complete  as  that  given, 
a  few  months  afterwards,  by  Clayton,^  a  veterinary 
surgeon  in  Gloucester,   and   published  by   Mr.   Cooke. 

"  The  Cow  Pox  begins  with  white  specks  upon  the  cow's 
teats,  which,  in  process  of  time,  ulcerate,  and  if  not  stopped, 
extend  over  the  whole  surface  of  the  teats,  giving  the  cow 
excruciating  pain  : — that  if  this  disease  is  suffered  to  continue 
for  some  time,  it  degenerates  into  ulcers,  exuding  a  malignant 
and  highly  corrosive  matter ;  but  this  generally  arises  from 
neglect  in  the  incipient  stage  of  the  disease,  or  from  some  other 
cause  he  cannot  explain  : — that  this  disease  has  not  a  regular 
process  of  commencing  and  terminating  without  a  remedy, 
because,    if  not    attended    to,    it    would    end    in    a    mortification 

'  Cooke.  Contributions  to  Pliysical  aiuf  Medical  Knowledge ,  collected 
hy  1  liomas  Beddoes,  p.  392.     1799. 


VACCINE  LYMPH.''  341 


of  the  teats,  and  probably  death  of  the  animal : — that  this 
disease  may  arise  from  any  cause  irritating  or  excoriating  the 
teats,  but  the  teats  are  often  chapped  without  the  Cow  Pox 
succeeding.  In  chaps  of  the  teats,  they  generally  swell ;  in 
the  Cow  Pox,  the  teats  seldom  swell  at  all,  but  are  gradually 
destroyed  by  ulceration  : — that  this  disease  first  breaks  out  upon 
one  cow,  and  is  communicated  by  the  milkers  to  the  whole  herd, 
but  if  one  person  was  confined  to  strip  the  cow  having  this 
disease,  it  would  go  no  farther: — that  the  Cow  Pox  is  a  local 
disease,  and  is  invariably  cured  by  local  remedies : — that  he 
never  knew  this  disease  extend  itself  in  the  slightest  degree  to 
the  udder,  unless  mortification  had  ensued,  and  that  he  can 
at  all  times  cure  the  Cow  Pox  in  eight  or  nine  days, 
by  his  usual  local  remedies : — that  he  is  conversant  with  the 
diseases  of  the  horse,  and  extensively  employed,  particularly  in 
curing  the  Grease  : — that  he  cannot  recollect  ever  to  have  had 
horses  with  the  Grease  and  cows  with  the  Cow  Pox,  under 
cure  at  the  same  time,  and  at  the  same  farm : — that  he  is 
ver}'  certain  he  has  frequently  had  cows  with  the  Cow  Pox, 
where  no  horses  whatever  have  been  kept : — that  he  considers 
the  Grease  as  a  name,  having  great  latitude  in  the  diseases  of 
horses,  because  sometimes  it  may  be  cured  merely  by  topical 
remedies,  and  at  other  times  it  is  only  to  be  completed  by 
internal  remedies : — that  he  does  not  consider  the  Grease  an 
infectious  disease  amongst  horses,  since  greasy  horses  and  horses 
in  perfect  health  frequently  stand  in  stables  together  indiscrimi- 
nately, without  infecting  each  other ;  and  although  it  is  probable, 
if  the  discharge  of  Grease  was  to  be  applied  in  its  most  acrid 
state  to  the  heels  of  a  sound  horse,  it  would  inflame  and  excoriate 
them,  yet  it  would  not  produce  the  Grease  : — that  Grease  is  most 
prevalent  in  winter,  at  which  time  he  has  never  known  the  Cow 
Pox  to  occur,  and  therefore  cannot  think  it  at  all  probable  that  the 
Grease  can  have  the  least  influence  in  producing  the  Cow  Pox." 

Mr.    John    Sims,^    in    a    letter   dated    February    13th, 
1799,   corroborated  the  account  given  by  Clayton. 

'  ^\m?,,  Medical  and  Physical  Journal.     1799. 


342  COW  POX. 

"There  is  a  gentleman  of  eminence  in  the  law,  now  living  at 
Bristol,  who  has  had  the  Cow  Pox  thrice,  and  being  afterwards 
inoculated  for  the  Small  Pox,  had  it  in  so  great  abundance  that  his 
life  for  some  time  was  despaired  of  He  describes  the  Cow  Pox 
as  the  most  loathsome  of  diseases,  and  adds  that  his  right  arm 
was  in  a  state  of  eruption  both  the  first  and  the  second  time  from 
one  extremity  to  the  other;  the  pain  was  excessive,  and  his  fingers 
so  stiff  he  could  scarcely  move  them.  The  gentleman  alluded 
to  was  the  son  of  a  farmer  who  kept  seventy  cows,  of  which 
he,  being  then  a  lad,  milked  eighteen  himself;  they  were  all  of 
them  infected  with  this  disorder  at  one  time ;  he  caught  it,  and 
such  was  the  abhorrence  it  created  in  the  family  that  they  made 
no  use  of  the  milk  as  long  as  it  lasted.  He  never  heard,  nor  does 
he  believe,  that  this  complaint  originates,  as  supposed  by  Dr. 
Jenner,  from  any  communication  with  that  acrid  humour  called 
the  grease  in  horses." 

Dr.  Bradley,  one  of  the  editors  of  the  Medical  and 
Physical  Journal,  commenting  on  this  case,  says  : — 

"  What  this  gentleman  remarks  of  the  loathsomeness  of  the 
disease,  although  a  circumstance  overlooked  in  Dr.  Jenner's 
account,  appears  to  be  in  itself  a  formidable  objection,  should  it 
be  lound  to  answer  the  purpose  for  which  it  has  been  recom- 
mended." 

Dr.  Bradley,  in  the  same  paper,  briefly  referred  to 
the  outbreak  of  Cow  Pox  which  occurred  in  London  in 
February  1799,  and  gave  a  coloured  plate  of  the 
disease  on  the  arm  and  fingers  of  a  milker.  The 
Cow  Pox,  he  adds,  in  this  instance,  "  appears  to  have 
been  very  mild,  for  no  loss  was  experienced  by  the 
farmers  from  the  deficiency  of  milk  as  usually  happens." 

This     early    description    was    supplemented     by    an 


"  VACCIATE  LYMPH r  343 


account  of  Cow  Pox '  by  Mr.  Lawrence,  author  of  A 
Philosophical  and  Practical  Treatise  on  Horses  and  on 
the  Moral  Duties  of  Man  towards  the  Brnte  Creation. 
This  article  on  Cow  Pox  not  only  affords  further  evi- 
dence of  this  disease  being  known  to  those  who  had 
the  care  of  cattle,  before  Jenner's  paper  was  published, 
but  it  shows  that  it  had  also  been  made  the  subject 
of  practical  observation  and  study,  by  veterinary 
surgeons. 

Lawrence  was  of  opinion  that  the  disease  had  no 
connection  with  grease,  and  thus  relates  his  experi- 
ence : — 

"  Concerning  the  real  aetiology  of  the  disease,  I  have,  for  many 
years,  been  without  any  uncertainty  in  my  opinion.  Too  sudden 
repletion  and  thickening  of  the  fluids,  after  the  fatigue  of  long 
driving  and  inanition  is  an  auxiliary  and  accelerating  cause  of 
Pox  upon  the  teats,  accompanied  by  low  fever,  considerable 
debility,  and  a  diminution  both  of  the  quantity  and  quality  of  the 
milk.  This  hypothesis,  1  think,  will  at  least  not  be  condemned 
as  irrational,  when  it  is  considered  that  the  disease  is  nearly  or 
altogether  unknown,  except  in  the  dairy  counties,  and  in  large 
towns  where  the  animals  which  are  its  victims  are  congregated  in 
such  great  numbers  and  stowed  so  close. 

"  That  it  is  often  taken  in  so  slight  a  way  as  to  have  no  preven- 
tive effect  of  the  Small  Pox,  I  apprehend  pretty  numerous  proofs 
might  be  obtained. 

"  The  Pox  among  cows  I  always  supposed  to  arise  from  the 
contagion  of  their  own  atmosphere ;  a  cause  fully  adequate  to  the 
effect  produced  ;  and  this  effect  ceases  with  the  cause  or  from 
the  influence  of  some  casual  and  unknown  cause,  and  is  repro- 
duced indefinitely  with  the  recurrence  of  the  original  cause. 

1  Med.  and Phys.  Jottrn.,  vol.  ii.,  p.  113.     April  1799. 


344  CO  W  POX. 

"  Whatever  may  be  the  fate  of  Cow  Pox  inoculation  it  has  and  will 
give  further  occasion  to  a  pretty  large  and  open  discussion,  which  is 
always  beneficial,  as  having  a  tendency  to  produce  discovery  and 
promote  improvement,  and  when  the  public  ardour  for  the  present 
topic  shall  have  become  a  little  cool  and  satisfied,  I  hope  it  will  be 
turned  by  enlightened  men  towards  another,  perhaps  of  nearly  as 
great  consequence,  namely,  the  prevention  of  the  original  malady 
in  the  animals  themselves.  Those  who  had  witnessed  it  and  only 
reflected  upon  the  excessive  filth  and  nastiness  which  must  unavoid- 
ably mix  with  the  milk  in  an  infected  dairy  of  cows,  and  the  corrupt 
and  unsalubrious  state  of  their  produce  in  consequence,  will  surely 
join  me  in  that  sentiment." 

Lawrence  was  almost  a  century  before  his  time.  Cow 
Pox  was  not  again  brought  forward  in  this  Hght  until 
1887-88,  when  I  reported  the  "filth  and  nastiness"  at  a 
Wiltshire  Farm,  and  advocated  the  advisability  of  placing 
this  disease  under  the  Contagious  Diseases  (Animals)  Act. 

Characters  of  the  Disease  in  the  Cow. 

The  numerous  details,  wanting  in  the  early  accounts 
of  Cow  Pox,  have  been  supplied  by  the  painstaking  and 
laborious  researches  of  Robert  Ceely,^  From  his  clas- 
sical papers  in  the  Transactions  of  the  Provincial  Medical 
Journal,  we  have  a  complete  picture  of  the  features  of 
the  natural   disease  in  the  cow. 

In  Ceely's  experience  in  the  Vale  of  Aylesbury,  outbreaks 
occurred  at  irregular  intervals,  most  commonly  appearing  about 
the  beginning  or  end  of  the  spring ;  rarely  during  the  height 
of  summer.  There  were  outbreaks  at  all  periods,  from  August 
to  May  and  the  beginning  of  June;  cases  also  being  met  with  even 
in  autumn  and  the  middle  of  winter,  after  a  dry  summer.     The 

'    Vide  vol.  ii.,  p.  363,  ct  scq. 


"  VACCINE  LYMPH r  345 


disease  was  occasionally  epizootic,  or  occurring  at  times  in 
several  farms  at  no  great  distance  from  each  other,  but  more 
commonly  sporadic  or  nearly  solitary.  It  was  to  be  seen  some- 
times at  several  contiguous  farms  ;  at  other  times,  at  one  or  two 
farms.  Many  years  might  elapse  before  it  occurred  at  a  given 
farm  or  vicinity,  although  all  the  animals  might  have  been 
changed  in  the  meantime.  Cow  Pox  had  broken  out  twice  in 
five  years  in  a  particular  \'icinity,  and  at  two  contiguous  farms, 
while  at  a  third  adjoining  dairy,  in  all  respects  similar  in  local 
and  other  circumstances,  it  had  not  been  known  to  exist  for 
forty  years.  It  was  sometimes  introduced  into  a  dairy  by 
recently  purchased  cows.  Twice  it  had  been  known  to  be  so 
introduced  by  milch  heifers.  It  was  considered  that  the  disease 
was  peculiar  to  the  milch  cow  ;  it  came  primarily  while  the  animal 
was  in  that  condition,  and  it  was  casually  propagated  to  others 
by  the  hands  of  the  milkers.  Sturks,  dry  heifers,  dry  cows, 
and  milch  cows  milked  by  other  hands,  grazing  in  the  same 
pastures,  feeding  in  the  same  sheds,  and  at  contiguous  stalls, 
remained  exempt  from  the  disease. 

For  many  years  past,  however,  the  spontaneous  origin  of 
Cow  Pox  had  not  been  doubted  in  the  Vale  of  Aylesbury.  In 
all  the  cases  that  Ceely  had  noticed  he  never  could  discover  the 
probability  of  any  other  source. 

Condition  of  Animals  primarily  affected. — There  was  much 
difficulty  in  determining  with  precision  at  all  times,  whether  this 
disease  arose  primarily  in  one  or  more  individuals  in  the  same 
dairy.  Most  commonly,  however,  it  appeared  to  be  solitary. 
The  milkers  believed  that  they  were  able  to  point  out  the  in- 
fecting individual.  In  two  instances,  there  could  be  very  little 
doubt  on  this  point.  In  August  1 838  three  cows  were  affected 
with  the  disease.  The  first  was  attacked  two  months  after  calving 
and  seven  weeks  after  weaning.  This  animal  was  considered  to 
be  in  good  health,  but  it  looked  out  of  condition.  She  had  heat 
and  tenderness  of  teats  and  udder  as  the  first  noticed  signs.  The 
other  two  were  affected  in  about  ten  days.  In  December  1838,  in 
a  large  dairy,  a  milch  cow  slipped  her  calf,  had  heat  and  induration 
of  the  udder  and  teats,  with  vaccine  eruption,  and  subsequently 
leucorrhoea    and    greatly    impaired     health  ;     the    whole    dairy, 


346  CO  TV  POX. 


consisting  of  forty  cows,  and  some  of  the  milkers,  became  sub- 
sequently affected.  in  another  dairy,  at  the  same  time,  it  first 
appeared  in  a  heifer  soon  after  weaning,  and  in  about  ten  or 
twelve  days,  extended  to  five  other  heifers  and  one  cow,  milked 
in  the  same  shed,  and  it  also  affected  the  milkers.  In  another 
dairy,  at  the  same  time,  thirty  cows  were  severely  affected,  and 
also  one  of  the  milkers.  It  appeared  to  arise  in  a  cow  two  months 
after  calving.  The  only  symptoms  noticed  were  that  the  udder 
and  teats  were  tumid,  tender,  and  hot,  just  before  the  disease 
appeared. 

Condition  of  Animals  casually  affected. — In  some  animals  the 
attack  was  less  severe  than  in  others,  depending  on  the  state  and 
condition  of  the  skin  of  the  parts  affected,  and  the  constitution  and 
habits  of  the  animal.  It  was  sometimes  observed  to  diminish 
the  secretion  of  milk,  and  in  most  cases  it  commonly  did  affect 
the  amount  obtained  artificially ;  with  this  exception,  and  the 
temporary  trouble  and  accidents  to  the  milk  and  the  milkers, 
little  else  was  observed ;  the  animal  continued  to  feed  and 
graze  apparently  as  well  as  before.  The  topical  effects  varied 
very  much  in  different  individuals,  the  mildness  or  severity 
being  greatly  influenced  by  temperament  and  condition  of  the 
animal,  and  especially  by  the  state  of  the  teats  and  udder,  and 
the  texture  and  vascularity  of  the  skin  of  the  parts  affected. 
Where  the  udder  was  short,  compact,  and  hairy,  and  the  skin 
of  the  teats  thick,  smooth,  tense,  and  entire,  or  scarcely  at  all 
chapped,  cracked,  or  fissured,  the  animal  often  escaped  with  a 
mild  affection,  sometimes  with  only  a  single  vesicle.  But  where 
the  udder  was  voluminous,  flabby,  pendulous,  and  naked,  and  the 
teats  long  and  loose,  and  the  skin  corrugated,  thin,  fissured, 
rough,  and  unequal,  then  the  animal  scarcely  ever  escaped  a 
copious  eruption.  Hence,  in  general,  heifers  suffered  least  and 
cows  most  from  the  milkers'  inoculations  and  manipulations. 

Progress  of  the  Disease. — Cow  Pox,  once  arising  or  introduced, 
and  the  necessary  precautions  not  being  adopted  in  time,  appeared 
in  ten  or  twelve  days,  on  many  more,  in  succession,  so  that  among 
twenty-five  cows  perhaps  by  the  third  week  nearly  all  would 
be  affected  ;  but  five  or  six  weeks  or  more  were  required  to 
see  the  teats  perfectly  free  from  the  disease. 


VACCINE  LYMPH r  347 


Propagation  by  the  Hand  of  the  Milker. — Ceely  was  able  to 
confirm  the  way  in  which  the  disease  was  said  to  spread.  In 
December  1838,  on  a  large  dairy  farm,  where  there  were  three 
milking-sheds,  Cow  Pox  broke  out  in  the  home  or  lower  shed. 
The  cows  in  this  shed  being  troublesome,  the  milker  from  the 
upper  shed,  after  milking  his  own  cows,  came  to  assist  in  this 
for  several  days,  morning  and  evening,  when,  in  about  a  week 
some  of  his  own  cows  began  to  exhibit  the  disease.  It  appears 
that,  having  chapped  hands,  he  neglected  washing  them  for  three 
or  four  days  at  a  time,  and  thus  seemed  to  convey  the  disease 
from  one  shed  to  another.  During  the  progress  of  the  disease 
through  this  shed,  one  of  the  affected  cows,  which  had  been 
attacked  by  the  other  cows,  was  removed  to  the  middle  shed,  where 
all  the  animals  were  perfectly  well.  This  cow,  being  in  an 
advanced  stage  of  the  disease,  and  of  course  difficult  to  milk 
and  dangerous  to  the  milk  pail,  was  milked  first  by  a  juvenile 
milker  for  three  or  four  days  only,  when,  becoming  unmanageable 
by  him,  her  former  milker  was  called  in  to  attend  exclusively  to 
her.  In  less  than  a  week  all  the  animals  of  this  shed  showed 
symptoms  of  the  disease,  though  in  a  much  milder  degree  than 
it  had  appeared  in  the  other  sheds,  fewer  manipulations  having 
been  performed  by  an  infected  hand. 

Topical  Syiuptoins  of  the  Natural  Disease. — For  these,  Ceely 
was  almost  always,  in  the  early  stage,  compelled  to  depend 
on  the  observations  and  statements  of  the  milkers.  They  stated 
that  for  three  or  four  days,  without  any  apparent  indisposi- 
tion, they  noticed  heat  and  tenderness  of  the  teats  and  udder, 
followed  by  irregularity  and  pimply  hardness  of  these  parts, 
especially  about  the  bases  of  the  teats,  and  adjoining  the  vicinity 
of  the  udder ;  that  these  pimples  on  skins  not  very  dark 
were  (jf  a  red  colour,  and  generally  as  large  as  a  vetch  or  a 
pea,  and  quite  hard,  though  in  three  or  four  days  many  of 
these  increased  to  the  size  of  a  horse-bean.  Milking  was 
generally  very  painful  to  the  animal ;  the  tumours  rapidly  in- 
creased in  size,  and  some  appeared  to  run  into  vesication  on 
the  teats,  and  were  soon  broken  by  the  hands.  Milking  now 
becomes  a  troublesome  and  occasionally  a  dangerous  process. 
Ceely  adds  : — "  It    is    very  seldom    that    any   person    competent 


348  COW  POX. 


to  judge  of  the  nature  of  the  ailment  has  access  to  the  animal 
before  the  appearance  of  the  disease  on  others  of  the  herd,  when 
the  cow  first  affected,  presents  on  the  teats  acuminated,  ovoid,  or 
globular  vesications,  some  entire,  others  broken,  not  infrequently 
two  or  three  interfluent ;  those  broken  have  evidently  a  central 
depression  with  marginal  induration  ;  those  entire,  being  punc- 
tured, diffuse  a  more  or  less  viscid  amber-coloured  fluid,  collapse, 
and  at  once  indicate  the  same  kind  of  central  and  marginal 
character.  They  appear  of  various  sizes,  from  that  of  a  pin's 
head,  evidently  of  later  date,  either  acuminated  or  depressed,  to 
that  of  an  almond  or  a  filbert,  or  even  larger.  Dark  brown  or 
black  solid  unifonn  crusts,  especially  on  the  udder  near  the  base 
of  the  teats,  are  visible  at  the  same  time,  some,  much  larger,  are 
observed  on  the  teats ;  these,  however,  are  less  regular  in  form 
and  less  perfect.  Some  are  nearly  detached,  others  quite  removed, 
exhibiting  a  raw  surface  with  a  slight  central  slough.  On  the 
teats,  the  crusts  are  circular,  oval,  oblong,  or  irregular ;  some 
flatter,  others  elevated  ;  some  thin  and  more  translucent,  being 
obviously  secondar}^  The  appearance  of  the  disease  in  different 
stages,  or  at  least,  the  formation  of  a  few  vesicles  at  different 
periods,  seems  very  evident.  The  swollen,  raw,  and  encrusted 
teats  seem  to  produce  uneasiness  to  the  animal  only  while  sub- 
jected to  the  tractions  of  the  milkers,  which  it  would  appear  are 
often  nearly  as  effectual  as  usual."  Referring  again  to  the  cha- 
racter of  the  vesicles,  Ceely  says  that  those  "  fortunate  enough  to 
have  an  opportunity  of  watching  the  disease  in  its  progress  ma}' 
observe  that  when  closely  examined  they  present  the  following 
characters  : — In  animals  of  dark  skin,  at  this  period,  the  finger 
detects  the  intumescent  indurations  often  better  than  the  eye,  but 
when  closely  examined,  the  tumours  present,  at  their  margins  and 
towards  their  centres,  a  glistening  metallic  lustre  or  leaden  hue  ; 
but  this  is  not  always  the  case,  for  occasionally  they  exhibit  a 
yellowish  or  yellowish-white  appearance." 

In  describing  more  fully  the  crust,  Ceely  said  that  "large  black 
solid  crusts,  often  more  than  an  inch  or  two  in  length,  are  to  be  seen 
in  different  parts  of  these  organs,  some  firmly  adherent  to  a  raw 
elevated  base,  others  partially  detached  from  a  raw,  red,  and  bleed- 
ing surface ;  many  denuded,  florid,  red,  ulcerated  surfaces,  with  small 


Faring  pagt'o^R 
PLATE    IX. 


^^: 


• 


O 

M 
o 

o 
o 

p 


VACCINE  LYMPH r  349 


central  sloughs  secreting  pus  and  exuding  blood,  the  teats  exceedingly 
tender,  hot,  and  swollen.  ...  In  some  animals,  under  some  cir- 
cumstances, this  state  continues  little  altered  till  the  third  or 
fourth  week,  rendering  the  process  of  milking  painful  to  the  animal, 
and  difficult  and  dangerous  to  the  milker."  ' 

"  In  many,  however,  little  uneasiness  seems  to  exist.  The  parts 
gradually  heal ;  the  crusts,  although  often  partially  or  entirely 
renewed  and  renewed,  ultimatel}^  separate,  leaving  apparently  but 
few  deep  irregular  cicatrices,  some  communicating  with  the  tu- 
buli  lactiferi,  the  greater  part  being  regular,  smoothly-depressed, 
circular,  or  oval." 

With  regard  to  papulae,  "  the  milkers  seldom  notice  the  first 
period  of  papulation.  Nor  is  this  to  be  wondered  at.  It  is,  in 
truth,  very  difficult  for  an  experienced  observer,  at  all  times,  to 
escape  error  in  this  latter  particular,  and  oversights  will  occur  to 
the  most  vigilant  from  various  causes,  especially  from  peculiarity 
of  colour,  vascularity  and  texture  of  skin,  as  well  as  temperament 
of  the  individual." 

With  regard  to  central  depression  of  the  vesicles,  Ceely  found  that 
"  in  three  or  four  days  from  their  first  appearance  the  papulae  acquire 
their  vesicular  character,  and  have  more  or  less  of  central  depres- 
sion, continuing  gradually  to  increase.  In  three  or  four  days  more, 
they  arrive  at  their  fullest  degree  of  development,  and  sometimes  are 
surrounded  with  an  areola,  and  always  embedded  in  a  circumscribed 
induration  of  the  adjacent  skin  and  subjacent  cellular  tissue." 

If  we  carefully  analyse  this  description  of  Cow  Pox, 
we  find  that  we  have  a  most  faithful  account  of  the 
disease,  as  it  actually  occurred  under  Ceely 's  eyes.  But, 
here  and  there,  we  see  an  attempt  to  harmonise  these 
observations  with  the  classical  description  of  the  inocu- 
lated disease.  In  ordinary  vaccination,  we  recognise 
the  stages  of  the  papule,  the  vesicle  with  its  central 
depression,   the  scab,  and  the  scar.      And  Ceely,   it  will 

'  Compare  Plate  X. 


350  COW  FOX. 

be  observed,  describes  the  natural  Cow  Pox  under 
each  of  these  headings.  But  when  describing  the 
vesicles,  he  practically  admits  that  the  classical  character 
of  umbilication  is  absent,  for  he  says  that  those  broken 
had  evidently  a  central  depression  ;  and  again,  that 
vesicles,  three  or  four  days  after  the  appearance  of 
papules,  have  more  or  less  of  a  central  depression. 

There  can  be  little  doubt  that  in  the  use  of  these 
ambiguous  expressions,  Ceely  was  probably  misled  by 
constantly  having  in  his  mind  the  effects  of  ordinary  vac- 
cination. And  the  appearances  depicted  in  the  elaborate 
pictures  of  Cow  Pox  on  the  cow's  teats,  which  illustrate 
his  classical  memoir,  can  therefore  be  explained.  The 
second  plate  is  a  faithful  picture  of  the  disease  on  the 
teats  as  it  is  ordinarily  met  with.  [Plate  IX.]  The  first 
plate  is  apparently  a  composite  picture,  representing  the 
eruption  as  ordinarily  observed  in  the  cow,  and  a  number 
of  depressed  vesicles  as  they  appear  after  artificial  inocu- 
lation. The  outline  of  this  drawing  is,  I  am  of  opinion, 
distinctly  after  S^iCco .  It  is,  however,  an  improvement  on 
the  latter,  which  can  only  be  described  as  an  imaginary 
diagram,  representing  the  udder  and  teats  of  a  cow, 
covered  with  an  eruption  purporting  to  be  that  of  the 
natural  Cow  Pox.  Jenner  had  described  the  vesicles 
in  natural  Cow  Pox,  as  possessing  a  bluish  tint,  and 
Sacco  deliberately  represents  the  natural  disease  by  a 
drawing  of  clusters  of  vesicles  of  inoculated  Cow  Pox, 
coloured  bright  blue,  and   with  a  silvery  lustre.     Ceely 


Facing  page  350 . 
PLATE  X. 


o 

O 

o 

>-' 

H 


o 

(—1 
O 

p 

O 

M 

O 


VACCINE  LYMPH r 


351 


has  outlined  his  drawing  from  Sacco's,  but  he  has 
represented  the  crusts  and  scabs  on  the  teats  as  he 
really  saw  them,  though  he  has  unfortunately  added  the 
vesicular  stage,  as  he  always  wished  to  see  it.  1  say 
unfortunately,  for  while  Sacco's  plate  was  accepted  as 
a  genuine  representation  of  the  natural  disease  in  the 
cow  for  the  first  half  of  this  century,  Ceely's  plate 
has  been  accepted  (particularly  in  this  country)  for 
the  latter  half.  It  has,  to  my  knowledge,  been  used 
in  a  veterinary  school  to  represent  what  Cow  Pox 
would  be  like,   if  it  were  ever  again  discovered ! 

Hering  has  given  a  coloured  plate  of  the  natural 
Cow  Pox,  and  it  will  be  noticed  that  it  is  totally 
different  from  either  Sacco's  or  Ceely's  drawing.  On 
the  teats  are  a  number  of  oval  or  circular  bullous 
vesicles  and  crusts.  More  recently,  Layet  has  pointed 
out  the  same  character  in  the  Cow  Pox  discovered  at 
Cerons  in  1883.  The  characters  of  the  inoculated 
disease  were  wanting,  particularly  the  central  depression 
of  the  vesicle.  In  Wiltshire  I  could  only  distinguish 
on  the  cow's  teats,  globular  and  broken  vesicles, 
thick  prominent  crusts  and  ulcers ;  appearances  which 
had  very  little  in  common  with  the  characters  of  the 
inoculated  disease. 

Casual  Cow  Pox  on  the  Hands  of  Milkers. 

The  early  accounts  of  the  "loathsome"  character 
of  the    disease    will   appear    by   no    means    exaggerated 


352  CO  IV  POX. 

to  those,  who  have  had  an  opportunity  of  studying 
its  effects  on  the  hands  of  milkers,  or  indeed  to  those 
who  have  made  themselves  familiar  with  the  descrip- 
tions eiven  bv  lenner  and  others.  To  illustrate  this,  I 
will  briefly  refer  to  some  of  Jenner's  cases  : — 

"Joseph  Merret  had  several  sores  on  his  hands:  swelUng  and 
stiffness  in  each  axilla,  and  much  indisposition  for  several  days. 

"  Mrs.  H.  had  sores  upon  her  hands,  which  were  communicated  to 
her  nose,  which  became  inflamed  and  very  much  swollen. 

"  Sarah  Wynne  had  Cow  Pox  in  such  a  violent  degree  that  she 
was  confined  to  her  bed,  and  unable  to  do  any  work  for  ten  days. 

"  William  Rodway  was  so  affected  by  the  severity  of  the  disease 
that  he  was  confined  to  his  bed. 

"  William  Smith  had  several  ulcerated  sores  on  his  hands,  and 
the  usual  constitutional  symptoms,  and  was  affected,  equally 
severely,  a  second  and  a  third  time. 

"  William  Stinchcomb  had  his  hand  very  severely  affected  with 
several  corroding  ulcers,  and  a  considerable  tumour  in  the  axilla. 

"  Sarah  Nelmes  had  a  large  pustulous  sore  on  the  hand  and  the 
usual  symptoms. 

"A  girl  had  an  ulceration  on  the  lip  from  frequently  holding  her 
finger  to  her  mouth  to  cool  the  raging  of  a  Cow  Pox  sore  by  blow- 
ing upon  it. 

"  A  YOUNG  WOMAN  had  Cow  Pox  to  a  great  extent,  several  sores 
which  maturated  having  appeared  on  the  hands  and  wrists. 

"A  YOUNG  WOMAN  had  several  large  suppurations  from  Cow  Pox 
on  the  hands." 


Pearson  met  with  similar  experiences  in  his  investi- 
gations, and  was  informed  of  others. 

"  Thomas  Edinburgh  was  so  lame  from  the  eruption  of  Cow 
Pox  on  the  palm  of  the  hand,  as  to  necessitate  his  being  for  some 
time  in  hospital.      For  three  days  he  had  suffered  from  pain  in  the 


' '  VA  CCINE  L  YMPH. "  353 


armpits,  which  were  swollen  and  sore  to  the  touch.  He  described 
the  disease  as  uncommonly  painful,  and  of  long  continuance. 

"A  SERVANT  at  a  farm  informed  Pearson  that  in  Wiltshire  and 
Gloucestershire,  the  milkers  were  sometimes  so  ill  as  to  lie  in  bed 
for  several  days. 

"  Mr.  Fran'cis  said  that  Cow  Pox  was  very  apt  to  produce 
painful  sores  on  the  hands  of  milkers. 

"  A  SERVANT  of  Mr.  Francis  said  that  Cow  Pox  affected  the 
hands  and  arms  of  the  milkers,  with  painful  sores  as  large  as  a 
sixpence. 

"  Mr.  Dolling  described  the  disease  as  a  swelling  under  the 
arm,  chilly  fits,  etc.,  not  different  from  the  breeding  of  the  Small 
Pox.  After  the  usual  time  of  sickening,  namely,  two  or  three  days, 
there  is  a  large  ulcer  not  unlike  a  carbuncle,  which  discharges 
matter. 

"  Dr.  Pulteney  described  the  disease  as  causing  '  a  sore- 
ness and  swelling  of  the  axillary  glands  as  under  inoculation 
for  the  Small  Pox,  then  chilliness  and  rigors  and  fevers,  as  in 
the  Small  Pox.'  Two  or  three  days  afterwards,  abscesses,  not 
unlike  carbuncles,  appear  generally  on  the  hands  and  arms,  which 
ulcerate  and  discharge  much  matter. 

"Mr.  Bird  wrote  a  short  account  of  Cow  Pox,  'It  appears  with 
red  spots  on  the  hands,  which  enlarge,  become  roundish,  and 
suppurate,  tumours  take  place  in  the  armpit,  the  pulse  grows  quick, 
the  head  aches,  pains  are  felt  in  the  back  and  limbs,  with  sometimes 
vomiting  and  delirium.' 

"Annie  Francis  had  pustules  on  her  hands  from  milking  cows. 
These  pustules  soon  became  scabs,  which,  falling  off,  discovered 
ulcerating  and  very  painful  sores,  which  were  long  in  healing. 
Some  milk  from  one  of  the  diseased  cows,  having  spurted  on 
the  cheek  of  her  sister  and  on  the  breast  of  her  mistress, 
produced,  on  these  parts  of  both  persons,  pustules  and  sores 
similar  to  her  own  on  her  hands.'' 

Pearson  classified  the  cases  of  which  he  had  received 
information  into  : — 

I.   Those   in  which  the  patients   are  inflicted   with  so 
VOL.  I.  23 


354 


CO  W  POX. 


much  painful  inflammation  as  to  be  confined  to  their 
beds  for  several  days,  and  have  painful  phagedenic 
sores  for  several  months. 

2.  Those  cases  which  are  so  slight  that  the  patients 
are  not  confined  at  all,  but  get  well  in  a  week  or  ten  days. 

I  will  now  proceed  to  point  out  that,  in  more  recent 
times,   these  descriptions   have  been   confirmed. 

In  1836,  Cow  Pox  was  discovered  at  Passy,  near 
Paris,  and  was  investigated  by  Bousquet.-^  A  cow  had 
Cow  Pox  six  weeks  after  calving.  Bousquet  had  no 
opportunity  of  seeing  the  eruption  in  the  early  stage,  but 
at  the  time  of  his  examination,  he  found  reddish-brown 
crusts  on  the  teats,  which  later  gave  place  to  puckered 
scars.  The  milk-woman,  Fleury,  who  had  had  Small 
Pox,  nevertheless  contracted  the  disease  from  the  cow. 
She  had  several  vesico-pustules  on  the  right  hand  and 
on  her  lips.  A  vesico-pustule  on  her  hand,  when 
opened  with  a  lancet,  discharged  like  an  abscess. 

Ceely,^  in  1840-42,  very  fully  described  the  casual 
disease  in  milkers  : 

"As  in  the  cow  so  in  man,  it  does  not  appear  always 
necessary  that  the  skin  should  be  visibly  fissured  or  abraded 
to  insure  infection,  although  very  often  we  find  those  conditions 
in  existence.  A  thin  and  vascular  skin  seems  capable  of 
absorbing  lymph,  if  copiously  applied  and  long  enough  retained. 
The  parts  upon  which  the  disease  is  commonly  observed  are 
the  back  of  the  hands,  particularly  between   the  thumb  and  fore- 


'    Vide  vol.  ii.,  p.  312. 
^  Ceely,  loc.  cit. 


VACCINE  LYMPH."  355 


finger,  about  the  flexures  of  the  joints  and  on  the  palmar, 
dorsal,  and  lateral  aspects  of  the  fingers.  The  forehead,  eye- 
brows, nose,  lips,  ears,  and  beard,  arc  often  implicated  from 
incautious  rubbing  with  the  hands,  during  or  soon  after  milking. 
In  women,  the  wrists  and  lower  parts  of  the  naked  forearm 
coming  in  contact  with  the  teats  arc  apt  to  be  affected.  If 
the  skin  of  the  hands  be  very  thin  and  florid,  especially  if 
chaps  and  fissures  abound,  the  individual  often  suffers  severely, 
having,  soon  after  the  decline  of  the  disease,  abscesses  and 
sinuses  of  the  subcutaneous  cellular  tissue  and  often  considerable 
swelling  and  inflammation  of  the  absorbents  and  the  axillary 
glands.  The  inflamed  spots  or  papulae  which  announce  the 
disease  are  more  circumscribed,  better  defined,  harder,  deeper, 
and  more  acuminate,  than  the  papulae  produced  by  some  of  the 
other  contagious  eruptions  of  the  cow.  They  vary  in  colour 
from  a  deep  rose  to  a  dark  damask  or  purple  hue,  according 
to  the  vascularity  and  texture  of  the  parts  affected.  If  the 
papulae  be  small,  there  is  often  no  perceptible  central  depression 
in  the  early  period  of  their  change  to  the  vesicular  state  ;  but 
they  exhibit  an  ash-coloured  or  bluish,  rather  acuminated  apex, 
which  gradually  becomes  relatively  flatter  as  the  base  enlarges 
and  elevates,  when  the  central  depression  is  more  obvious  and 
exhibits  a  yellowish  tinge. 

"  Larger  vesicles,  especially  on  the  back  of  the  hand  and 
sides  of  the  fingers,  have  a  well-marked  central  depression  in 
the  early  stage,  and  often  a  livid  or  irregularly  ecchymosed 
appearance  similar  to  what  is  observed  on  the  cow  ;  when  fully 
developed,  the}^  present  a  bluish  or  slate-coloured  hue,  which 
increases  in  depth,  and  is  more  conspicuous  towards  their  decline. 
This  bluish  colour,  though  very  common,  is  often  absent,  even 
in  some  of  the  vesicles  on  the  same  hand.  It  evidently  depends 
upon  and  is  influenced  by  the  vascularity  of  the  part,  the 
greater  or  less  translucency  of  the  epidermis,  the  quantity  of 
lymph,  the  depth  and  extent  of  the  vesicle.  When  the  epidermis 
is  stripped  off  from  such  vesicles,  the  zone-like  adventitious 
membrane  appears  diaphanous,  and  has  a  bluish  or  livid  hue, 
derived,  doubtless,  from  the  highly  congested  state  of  its 
vessels  ;    here  and  there,  are  often    seen  spots  of  actual   ecchy- 


356  COW  POX. 


mosis.  Where  the  epidermis  is  thick,  the  vesicles  are  generally 
well  defined,  circular,  or  oval,  if  the  parts  will  admit,  and  have 
only  a  slight  slate-coloured  tint  in  the  centre,  but  more  frequently 
this  colour  is  superseded  by  an  opaque  white  or  a  dusky 
yellowish  hue.  Where  the  skin  is  loose,  thin,  dark,  or  dusky, 
the  vesicles  are  jagged,  irregular  and  puffed  at  their  margins, 
and,  saving  the  central  depression,  very  much  resemble  a  scald. 
In  size  they  vary  from  that  of  a  vetch  to  a  fourpenny-piece, 
sometimes  larger,  especially  when  depending  on  a  wound  or 
extensive  fissure.  The  vesicles  are  frequently  broken,  or,  when 
the  epidermis  is  thin,  spontaneously  burst,  causing  deep  sloughing^ 
of  the  skin  and  cellular  tissue  and  ulcerations,  which  slowly  heal. 
There  is  often,  consequently,  much  attendant  local  irritation  and 
considerable  symptomatic  fever. 

"Papular,  vesicular,  and  bullous  eruptions  are  occasionally  seen 
attendant  on  casual  Cow  Pox,  especially  in  young  persons  of 
sanguine  temperament  and  florid  complexion,  at  the  height  or 
after  the  decline  of  the  disease.  They  are  generally  of  the 
same  character  as  those  known  to  attend  the  inoculated  disease ; 
but  now  and  then  we  are  told  by  the  patients  \hat  these  eruptions, 
either  solitary  or  in  clusters,  resemble  the  vaccine  vesicles. 

"Although  the  casual  Cow  Pox  in  man  is  mostly  found  in 
those  who  have  not  previously  gone  through  variola  or  the 
vaccine,  it  is  b}'  no  means  rare  to  meet  with  it  on  persons 
who  have  passed  through  the  latter  and  a  few  who  have  had 
the  former  disease." 

To  illustrate  this  account  of  casual  Cow  Pox  in  man, 
I  will  give  the  particulars  of  cases  observed  by  Ceely, 
in  October,    1840. 

"  1.  Mr.  Pollard,  aet.  fifty-six.  When  first  observed,  the 
vesicles  on  the  hand  and  finger  had  burst,  the  secondary 
constitutional  symptoms  were  declining,  and  the  centres  of  the 
vesicles,  as  usual,  were  in  a  sloughing  state.  About  ten  days 
after  the  discovery  of  the  disease  on  the  cows,  the  patient 
observed  two  itching  small  pimples  on  the  site  of  the  present 
ulcers,   which,    according   to   his   account,   ran   the   normal  course 


VACCINE  LYMPHr 


357 


of  the  vaccine  vesicle ;  as  soon  as  the  areolae  commenced, 
having  felt  scarcely  any  indisposition  before,  pain  and  tenderness 
of  the  axillary  glands,  with  the  usual  constitutional  symptoms, 
arose,  and  gradually  increased  for  four  or  five  days,  but  were 
never  severe  enough  to  confine  him  to  the  house.  When  seen 
later  the  topical  inflammation  was  rapidly  departing,  the  vesicles 
were  quite  broken  up,  and  a  blackish-brown  slough  adhered 
to  their  centres,  their  base  being  surrounded  with  an  elevated 
induration  of  a   hard   red  colour. 

"  II.  Joseph  Brooks,  set.  seventeen,  felt  the  glands  and 
lymphatics  of  his  neck  stiff  and  tender;  and  noticed  a  pimple 
on  the  temporo-frontal  region,  which  he  could  not  resist  scratch- 
ing. He  also  observed  a  red  pimple  on  his  finger,  of  the 
size  of  a  pin's  head,  and  one  very  small  one  on  the  thumb. 
In  neither  situation  was  there  to  his  knowledge  any  visible 
wound   or  abrasion   of  the  cuticle. 

"On  the  2 1st,  he  had  headache,  general  uneasiness,  and  pains 
of  the  back  and  limbs,  with  tenderness  and  pain  in  the  course 
of  the  corresponding  lymphatic  vessels  and  absorbent  glands, 
particularly  of  the  axilla,  which  increased  till  the  23rd,  when 
nausea  and  vomiting  took  place.  His  right  eyelids  became 
swollen,  and  were  closed  on  that  day ;  but  after  this  period 
he  became  better  in  all  respects,  never  having  been  confined 
to  the  house,  although  disabled  from  work.  The  engravings 
[Plates  XL,  XII.]  represent  the  vesicles  as  they  appeared  on  the 
23rd,  when  the  constitutional  and  local  symptoms  were  subsiding. 
The  vesicle  on  the  temporal  region  had  a  well  marked  central 
depression,  with  a  slight  crust,  a  general  glistening  appearance, 
and  was  of  a  bright  rose  or  flesh  colour,  with  a  receding 
areola ;  and  there  was  an  inflamed,  tumid,  and  completely 
closed  state  of  the  corresponding  eyelids. 

"  On  the  finger,  the  vesicle  was  small  and  flat,  with  a 
slightly  depressed  centre,  containing  a  minute  crust.  It  had 
a  beautiful  pearly  hue,  and  was  seated  on  a  bright  rose- 
coloured  slightly  elevated  base.  On  the  thumb,  the  vesicle 
was  also  flat  and  broad,  but  visibly  depressed  towards  the 
centre,  where  there  appeared  a  transverse  linear-shaped  crust, 
corresponding,     doubtless,    with    a    fissure     in     the    fold    of    the 


358  COW  FOX. 


cuticle.  The  vesicle  was  of  a  dirty  yellowish  hue,  and  visibly 
raised  on  an  inflamed  circumscribed  base.  Lymph  was  obtained 
from  the  vesicle  on  the  temple,  in  small  quantity,  by  carefully 
removing  the  central  crust,  and  patiently  waiting  its  slow 
exudation.  In  this,  as  in  most  other  respects,  it  strikingly 
resembled  the  vesicle  on  the  cow,  and  appeared  as  solid  and 
compact.  The  lymph  was  perfectly  limpid,  and  very  adhesive. 
No  lymph  was  taken  from  the  vesicles  on  the  finger  and  thumb, 
with  a  view  to  avoid  any  interruption  of  their  natural  course. 

"On  the  26th  and  27th,  when  the  redness  and  elevation  of 
the  base  of  the  vesicles  had  materially  diminished,  the  vesicles 
themselves  had  become  greatly  enlarged.  On  the  thumb  and 
finger,  the}^  were  loosely  spread  out  at  the  circumference,  each 
having  a  dark  and  deep  central  slough.  On  the  temple,  the 
margin  of  the  vesicle  (as  on  the  cow)  was  firm  and  fleshy, 
its  diameter  being  nearly  ten  lines,  and  its  centre  filled  with 
a  dark  brown  firmly  adherent  slough.  In  about  seven  or  eight 
days,  with  the  aid  of  poultices,  the  sloughs  separated,  and 
the  deep  ulcers  healed,  leaving  cicatrices  like  variola,  deep, 
puckered,  and  uneven,  which  were  seen  on  the  25  th  of 
November.  The  scar  on  the  temple  was  nearly  as  large  on  the 
5th  of  December  as  the  vesicle  represented  in  the  engraving". 

"Joseph  White,  aet.  eighteen  ;  fair  complexion,  thin  skin.  Had 
never  before  had  variola  or  vaccine.  He  had  not  been  long 
engaged  in  milking  at  Dorton  before  he  received  the  infection ;  he 
first  noticed  the  pimples  on  the  thumb  and  dorsum  of  the  left 
hand  on  the  25th  of  May.  On  the  30th,  the  sixth  day  of  papu- 
lation,^ he  first  felt  the  mild  constitutional  symptoms  and  the 
axillary  swelling  and  tenderness.  The  next  day  these  symptoms 
increased  ;  but  on  the  following  day,  the  eighth  of  papulation, 
they  abated  ;  yet  as  his  hand  was  more  painful,  and  he  found 
himself  incapable  of  work,  he  called  on  Mr.  Knight  for  advice. 
Lymph  was  then  abstracted  and  used  by  that  gentleman  ;  the 
areolae  were  just  commencing.     On  the  2nd  of  June,  the    ninth 


From  our  inability  to  determine  the  precise  period  of  infection,  we  are 
obliged  to  reckon  from  the  earliest  period  of  recognised  papulation. 


Faci'ig  fage  358. 
PLATE  XI. 


CASUAL    cow    POX    (CEELY). 
Case  of  Joseph  Brooks,  Mile:er. 


7?JKaiU/mb.i),^iS>nJui 


FolloTjuing  Plate  XI 
PLATE   XII. 


CASUAL    cow    POX     (CEELY). 
Case  of  Joseph  White,  Mu-kee. 


TMantBmh^oJ/tSonJM 


VACCINE  LYMPH r 


359 


da}'  of  papulation,  he  came  to  Aylesbury,  when  the  following  ap- 
pearances were  observed.  On  the  side  of  the  thumb  [Plate  XIII.]. 
between  the  root  of  the  nail  and  above  the  last  articulation,  was 
a  flat  vesicle  of  a  dirty  white  hue,  with  a  slight  central  dis- 
colouration rather  than  depression,  and  a  pale  red  areola  extended 
around  the  vesicle  and  beyond  the  last  joint  of  the  thumb.  On 
the  back  of  the  hand  there  was  a  smaller  vesicle,  of  a  different 
colour  and  character  ;  it  was  visibly  raised,  overlapping  at  the 
outer  margin,  and  depressed  in  the  centre,  on  a  less  circum- 
scribed but  obvious  base.  The  vesicle  was  of  a  light  flesh  colour ; 
its  central  crust  dark  brown,  and  a  moderate  light  rose-coloured 
areola,  and  some  tumefaction  surrounded  and  raised  the  whole. 
A  small  red  imperfectly  vesiculated  pimple  was  seen  on  the  left 
cheek — noticed  by  the  patient  now  for  the  first  time.  The 
axillary  glands  and  absorbent  vessels  were  very  tender ;  and 
though  early  in  the  morning  the  patient  felt  generally  better, 
in  the  evening  there  was  increase  of  all  the  symptoms. 

^^Jiiiie  2)ni,  tenth  day  of  papulation.  —  To-day  worse  in  all 
respects;  both  vesicles  considerably  enlarged,  and  the  areolae 
much  increased.  There  was  considerable  tumefaction  of  the 
thumb  and  the  back  of  the  hand ;  and  the  absorbent  vessels, 
Mghly  inflamed,  could  be  traced  by  the  eye  into  the  axilla. 

^\June  \th,  eleventh  day  of  papulation. — The  vesicles  enlarging  . 
areolae  rapidly  subsiding ;  constitutional  symptoms  less  in  the 
morning,  but  in  the  evening  augmented  ;  the  areolae  then  quite 
gone,  but  much  puffiness  of  integuments  remaining  ;  and  some  red 
absorbents  still  visible  on  the  arm.  The  vesicle  on  the  face  now 
contains  a  light  amber  crust. 

'func  ^th,  twelfth  day  of  papulation. — Better  in  all  respects;  less 
tumefaction  of  the  hand,  etc.;  vesicles  expanding.  That  on  the 
thumb  was  of  a  dull  dirty  white  horn-colour,  and  it  had  still  a  dull 
red  areola  around  the  raised  and  tumid  base ;  the  centre  of  the 
Vesicle,  scarcely  depressed,  was  of  a  dirty  yellowish-brown  colour. 
On  the  hand  the  vesicle  was  of  a  dull  pearly  hue,  though  rather 
mure  glistening  than  before  ;  it  was  much  puckered  at  the  centre 
and  the  margin  :  tlie  centre  was  deeply  depressed,  and  contained 
a  small  dirty  3^ellowish-brown  crust.  The  areola  was  dull,  and 
brighter  than  that  on  the  thumb. 


36o  COW  POX. 

''June  8t/i,  fifteentJi  day  of  papulation. — The  vesicle  on  the 
thumb  [Plate  XIV.]  was  still  characteristic,  though  it  had  acquired 
a  vesicated  margin.  The  vesicle  on  the  hand  [Plate  XIV.]  was 
also  characteristic,  though  puffed  exceedingly  at  its  circumference. 
The  vesicle  on  the  face  was  now  capped  with  a  hard  light  brown 
crust  [Plate  XIV.]. 

''June  i2tJi,  nineteenth  day  oj papulation. — The  stage  of  ulceration 
was  fully  developed  [Plate  XIV.],  and  the  extent  of  topical  dis- 
organisation was  now  sufficiently  manifest. 

"  In  about  a  fortnight,  the  ulcers  were  perfectly  healed,  leaving 
scars  like  those  succeeding  variolae  or  any  other  disease  attended 
with  entire  destruction  of  the  corium." 

In  a  letter  to  Mr.  Badcock,  dated  April  3rd,  1845, 
Ceely,  referring  to  a  new  stock  of  lymph  raised  from 
a   milker's  hand,  wrote  : — 

"  In  the  enclosed  lymph  I  see  nothing  unusually  severe,  except 
on  very  thin  skins,  although  the  milker's  hand  exhibits  now  rough 
ulcers,  one  on  the  hand  deep  enough  to  encase  a  bean." 

After  Ceely 's  cases  in  1840-41,  no  cases  of  casual 
Cow  Pox  on  the  hands  of  milkers,  in  this  country,  were 
recognised  as  such  and  recorded  for  nearly  fifty  years. 
In  December  1887,  Cow  Pox  broke  out.  on  farms  near 
Cricklade  in  Wiltshire,  and  the  disease  was  communi- 
cated to  nearly  all  the  milkers. 

John  Rawlins,  milker,  informed  me  that  he  was  the  first  to 
catch  the  eruption  from  the  cows.  He  states  that  it  came  as  a 
hard,  painful  spot,  which  formed  "matter"  and  then  a  "big  scab." 
He  had  been  inoculated  about  seven  weeks  ago.  He  pointed 
to  the  scar  which  remained  on  his  right  hand.  This  scar  pre- 
sented the  characters  of  an  irregular  cicatrix,  indicating  con- 
siderable loss  of  substance.  He  states  that  he  had  also  two 
places  on  his  back,  where  he  supposes  he  had  inoculated  himself 


PLATE   XIII, 


CASUAL    COW    POX     (CEELY). 
Case  of  Joseph  White,  Milkek. 


Ttacf/aJmbAfyiSaiJ^. 


Fdtowntg  Plau-  XIII 
PLATE   XIV. 


MS-y.       i 


CASUAL     COW    POX     (CEELY). 
Case  of  Joseph  White,  Mixkek. 


VACCINE  LYAIPHr  361 


by  scratching.  He  had  continued  milking  ever  since,  but  had 
had  no  "  fresh  places." 

William  Hibbert,  milker.  He  states  that  he  was  inoculated 
from  the  cows  about  the  same  time  as  J.  R.  They  were  the 
two  milkers  of  the  herd  in  which  the  Cow  Pox  iirst  made  its 
appearance.  The  eruption  appeared  in  one  place  on  each 
hand.  He  pointed  to  two  irregular  scars  as  the  remains  of 
the  eruption. 

JosKPH  Lanfear,  milker,  states  that  he  also  caught  the 
disease  from  the  cows.  On  his  right  hand,  "  a  spot  appeared 
which  formed  a  blister,  then  discharged  matter,  and  produced 
a  bad  sore."  Lumps  formed  at  the  bend  of  his  elbow  and  in 
his  armpit.  He  lost  his  appetite,  felt  very  poorly,  and  was 
obliged  to  leave  off  work  for  two  or  three  days,  and  stay  at  home. 

He  states  that  about  a  fortnight  or  three  weeks  afterwards, 
while  milking  a  very  bad  case,  a  sore  on  his  left  hand,  resulting 
from  a  wound  with  a  rusty  nail,  became  inflamed,  and  another 
place  broke  out  at  the  tip  of  one  of  his  fingers,  but  he  was  not 
poorly,   nor  did   lumps    appear  in   his  left  armpit. 

William  King  works  on  the  farms,  but  was  put  on  as  a 
milker  to  take  the  place  of  one  of  the  others  with  bad  hands. 
After  his  fifth  or  sixth  milking,  that  is  to  say  about  three  days 
after  first  milking  the  cows,  pimples  appeared  on  his  hands, 
which  became  "  blistered  and  then  ran  on  to  bad  sores."  He 
pointed  to  three  irregular  scars  on  the  first  and  third  fingers  and 
palm  of  the  right  hand.  Lumps  appeared  in  his  elbow  and 
in  his  armpit,  but  he  did  not  feel  very  poorl}^  in  consequence. 

JAMES  Febry,  milker,  states  that  about  a  month  ago  he 
noticed  spots  which  appeared  on  both  hands.  His  fingers  swelled 
and  were  painful.  He  says  it  came  first  like  a  pimple  and  felt 
hard.  Then  it  "  weeped  out  "  water,  in  four  or  five  days.  There 
were  red  marks  creeping  up  to  his  arm.  There  was  a  sort 
of  throbbing  pain,  and  he  could  not  sleep  at  night. 

When  I  saw  him,  I  found  on  the  right  hand  a  scar,  but  on 
the  left  hand,  there  was  an  ulcer  about  the  size  of  a  shilling 
covered  with  a  thick  black  crust.  The  crust  was  partially 
detached  and  exposed  a  granulating  ulcer.  It  was,  in  this  stage, 
the  exact  counterpart  of  the  ulcers  on  the  cow's  teats. 


362  CO  W  POX. 

William  Hibbert,  jun.,  milker,  states  that  he  had  both 
hands  bad  about  a  month  ago.  First  the  index  finger  of  the 
left  hand,  and  then  the  knuckle  on  the  right  hand  and  between 
the  first  and  second  fingers. 

He  says  that  it  came  up  like  a  hard  pimple,  and  the  finger 
became  swollen  and  red.  After  a  few  days  it  "  weeped  out " 
water  and  then  matter  came  away.  Both  his  arms  were  swollen, 
but  his  left  arm  was  the  worst. 

About  a  fortnight  after,  he  noticed  kernels  in  his  armpits, 
which  were  painful  and  kept  him  awake  at  night.  His  arms 
became  worse,  he  could  not  raise  them,  and  he  had  to  give  up 
milking.     He  also  had  had  a  "bad  place"  on  the  lower  lip. 

On  examination,  I  found  that  the  axillary  glands  were  still 
enlarged  and  tender.  He  volunteered  the  statement  that  the 
places  were  just  like  the  sore  teats.     [Plate  XVII.,   Fig.  4.] 

John  Harding,  the  bailiff's  son,  also  milked  the  cows.  He 
had  a  sore  on  the  upper  lid  of  his  right  eye  and  on  his  left  hand. 
In  both  cases,  he  had  been  previously  scratched  by  a  cat,  and 
the  scratches  were  inoculated  from  the  cow's  teats.  The  right 
hand  also  had  been  inoculated.  The  eruption  broke  out  a 
fortnight  ago.  His  hands  were  swollen,  red,  and  hot.  He  felt 
very  poorly  and  went  to  bed.  Little  spots  like  white  blisters 
appeared  on  the  back  of  his  right  hand.  His  mother  remarked 
that  they  "  rose  up  exactly  as  in  vaccination."  Thick  dark  brown 
scabs  formed.  He  was  ver}'  ill  for  two  or  three  days,  but  did 
not  send  for  a  doctor.  He  had  painful  lumps  at  the  bend  of  his 
arm  and  in  the  armpit.  He  gave  up  milking  and  had  not  taken 
to  it  since. 

On  examining  him,  the  thick  crusts  on  his  right  hand  were 
identical  with  the  stage  of  scabbing  in  ordinary  vaccinia. 
[Plate  XV.].  The  scabs  fell  oft'  in  about  three  weeks  to  a  month 
and  left  permanent  depressed  scars. 

William  Plowman,  milker.  He  had  taken  the  place  of  one 
of  the  other  milkers  who  had  vesicles  on  his  fingers  and  had 
been  obliged  to  give  up  milking.  After  the  seventh  time  of 
milking,  he  noticed  a  small  pimple  on  his  right  cheek  (Nov.  27th). 
The  pimple  became  larger  and,  as  he  expressed  it,  "  rose  up 
like  a  blister." 


I 


Facing  page  362. 
PLATE   XV. 


ni,  aj  nitx.hiu.' 


CASUAL    COW    POX 
Ca.se  of  John  HAEDiNa,  Milkek. 


VACCINE  LYAIPHr  363 


On  December  2nd,  the  date  of  my  visit,  there  was  a  depressed 
vesicle  with  a  small  central,  yellowish  crust  and  a  tumid  margin, 
the  whole  being  surrounded  by  a  well-marked  areola  and  con- 
siderable surrounding  induration.     [Plate  XVI.,   Fig.    i.] 

After  puncturing  the  tumid  margin  and  collecting  clear  lymph 
in  a  number  of  capillary  tubes,  I  raised  this  central  incrustation 
and  observed  a  crater-like  excavation,  from  which  l^-mph  welled 
up  and  trickled  down  the  boy's  cheek. 

On  the  following  day,  the  crust  had  re-formed  and  was 
studded  with  coagulated  lymph.  The  areola  had  become  more 
marked,  and  on  pricking  the  margin  of  the  vesicle  the  contents 
were  slightl}^  turbid. 

From  this  day,  the  surrounding  infiltration  increased  enor- 
mously, the  whole  cheek  was  inflamed,  and  the  eyelids  so 
(Edematous  that  the  eye  was  almost  closed.  There  was  en- 
largement of  the  neighbouring  lymphatic  glands.  The  crust, 
which  had  re-formed,  thickened  day  by  day,  and  on  Dec.  9th, 
there  was  a  thick  reddish-brown  crust,  still  bearing  the  character 
of  central  depression,  situated  on  a  reddened,  raised,  and 
indurated  base.      [Plate  XVI.,   Fig.    2.] 

From  this  date,  the  surrounding  induration  gradually  diminished. 
The  crust  changed  in  colour  from  dark-brown  to  black,  and  finally 
fell  off  on  Dec.  15th,  leaving  an  irregular  depressed  scar.  This 
scar,  when  seen  several  months  afterwards  was  found  to  be  a 
permanent  disfigurement. 

A  vesicle  also  formed  on  the  thumb  of  the  left  hand.  Two 
days  after  the  pimple  appeared  on  his  cheek,  the  lad  sa3'S 
that  he  noticed  a  pimple  on  his  thumb,  and  this,  on  m}-  visit 
on  Dec.  2nd,  presented  a  greyish  flattened  vesicle,  about  the 
size  of  a  sixpence.  On  the  following  day,  its  vesicular  character 
was  much  more  marked,  and  a  little  central  crust  had  com- 
menced to  form.  [Plate  XVII.,  Fig.  i.]  On  Dec.  4th,  especially 
towards  the  evening,  the  margins  became  very  tumid,  giving 
it  a  marked  appearance  of  central  depression.  On  Dec.  5th,  I 
punctured  the  vesicle  at  its  margin  with  a  clean  needle,  and 
I  filled  a  number  of  capillary  tubes  from  the  beads  of  lymph 
which  exuded. 

On     Dec.     7th,     suppuration     had     commenced;     the    vesicle 


364  cow  POX. 

contained  a  turbid  fluid,  and  the  areola  was  well  marked.  [Plate 
XVII.,  Fig.  2.]  On  Dec.  9th  the  crust  had  assumed  a  peculiar 
slate-coloured  hue,  and,  on  pressing  it,  pus  welled  up  through  a 
central  fissure.  [Plate  XVII.,  Fig.  3.]  The  areola  had  increased, 
and  there  was  considerable  inflammatory  thickening.  The 
lymphatic  glands  in  the  armpit  were  enlarged  and  painful. 
Though  there  was  deep  ulceration,  which  left  a  permanent  scar, 
the  ulceration  did  not  assume  quite  so  severe  a  character  as  in 
some  of  the  other  milkers.  Possibly  this  may  be  accounted  for 
to  some  extent  by  the  fact  that  the  pock  was  covered  with  a 
simple  dressing,  instead  of  being  subjected  to  the  irritation  and 
injury  incidental  to  working  on  the  farm. 

There  were  in  all  eight  milkers,  varying  in  age  from  seventeen 
to  fifty-five,  who  contracted  the  disease  from  milking  the  cows. 
Seven  had  been  vaccinated  in  infancy,  but  not  since  ;  one  had 
been  revaccinated  on  entering  the  navy  at  fifteen.  They  were 
all  vaccinated  after  complete  recovery  from  the  casual  Cow  Pox 
(that  is  to  say,  from  three  to  four  months  afterwards),  and  were 
all  completely  protected.  On  the  other  hand,  two  milkers  who 
had  not  had  the  casual  Cow  Pox  were  vaccinated,  with  the 
result  in  one  of  typical  revaccination,  in  the  other  of  very 
considerable  local  irritation. 

Effects  of  Inoculation  of  Virulent  Cow  Pox 

Lymph. 

Severe  symptoms  are  not  limited  to  milkers  casually 
infected  from  the  cov^.  Occasionally,  intentional  inocula- 
tion of  fresh  virus  from  the  cow  reproduces  the  disease 
without  any  mitigation.      Thus   in   Jenner's  cases  ^ : — 

"James  Phipps.  The  incisions  assumed,  at  their  edges, 
rather  a  darker  hue  than  in  variolous  inoculation,  and  the 
efflorescence  around  them  took  on  more  of  an  erysipelatous  look. 
They  terminated  in  scabs  and  subsequent  eschars. 


^  Vide  vo\.  ii.,  p.  172. 


Facing  page  d&f 
PLATE   XVI. 


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PLATE   XVII 


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T7jtcaitBmlct3a^iSc-ulM. 


VACCINE  LYMPH."  365 


"  Susan  Phipps  was  inoculated  from  the  cow,  by  inserting 
matter  into   a  superficial   scratch,   on    Dec.    2nd. 

"  6th.     Appearances  stationar}-. 

"  7th.     The   inflammation   began   to   advance. 

"8th.  A  vesication  perceptible  on  the  edges,  forming  .  .  .  an 
appearance  not  unlike  a  grain  of  wheat  with  the  cleft  or  inden- 
tion in  the  centre. 

"  9th.     Pain  in  the  axilla. 

"  lOth.  A  little  headache;  pulse  no;  tongue  not  discoloured; 
countenance  in  health. 

"nth — 1 2th.  No   perceptible  illness;  pulse   about    100. 

"  13th.  The  pustule  was  now  surrounded  by  an  efflorescence 
interspersed  with  very  minute  pustules,  to  the  extent  of  about 
an  inch.  Some  of  the  pustules  advanced  in  size  and  maturated.  .  . 
The  child's  arm  now  showed  a  disposition  to  scab,  and  remained 
nearly  stationary  for  two  or  three  days,  when  it  began  to  run 
into  an  ulcerous  state,  and  then  commenced  a  febrile  indisposition, 
accompanied  with  an  increase  of  axillary  tumour.  The  ulcer 
continued  spreading  nearly  a  week,  during  which  time  the  child 
continued  ill.  when  it  increased  to  a  size  nearly  as  large  as  a 
shilling.  It  began  now  to  discharge  pus  ;  granulations  sprung 
up  and  it  healed. 

"  Mary  Hearn,   inoculated  from  the  arm  of  Susan  Phipps. 

"6th  day.  A  pustule  beginning  to  appear,  slight  pain  in  the 
axilla. 

"  /th.  A  distinct  vesicle  formed. 

"  8th.  The  vesicle   increasing  ;  edges  very   red. 

"  9th.   No  indisposition  ;    pustule  advancing. 

"  lOth.  The  patient  felt  this  evening  a  slight  febrile  attack. 

"nth.   Free  from   indisposition. 

"  1 2th  and  13th.  The  same. 

"  14th.  An  efflorescence  of  a  faint  red  colour  extending  several 
inches  round  the  arm.  The  pustule,  beginning  to  show  a  dis- 
position to  spread,  was  dressed  with  an  ointment  composed  of 
hydrarg.  nit.  nib.  and  iiiig.  ccmc.  The  efflorescence  itself  was 
covered  with  a  plaster  of  iing.  hydr,  fort.  In  six  hours  it  was 
examined,  when  it  was  *  found  that  the  efflorescence  had  totally 
disappeared.'      The    application    of    the    ointment    of  hydr.    nit. 


366  COW  FOX. 


rub.  was  made  use  of  for  three  days,  when  the  state  of  the 
pustule  remaining  stationary,  it  was  exchanged  for  the  iiiig. 
hydr.  nit.  This  appeared  to  have  a  more  active  effect  than  the 
former,  and  in  two  or  three  days,  the  virus  seemed  to  be 
subdued,  when  a  simple  dressing  was  made  use  of;  but  the  sore 
again  showing  a  disposition  to  inflame,  the  iing.  hydrarg.  nit. 
was  again  applied,  and  soon  answered  the  intended  purpose 
effectually." 

Jenner's  lymph  was  employed  by  Mr.  Cline  with 
similar  results. 

"The  child  sickened  on  the  seventh  day,  and  the  fever  which 
was  moderate  subsided  on  the  eleventh.  .  .  .  The  ulcer  was 
not  large  enough  to  contain  a   pea." 

But  the  lymph  raised  by  Pearson  and  Woodville 
from  the  "  mild  "  outbreak  of  Cow  Pox  in  London 
produced  a  correspondingly  mild  effect.  This  was  the 
result,  for  example,  in  the  very  first  case  inoculated  by 
Woodville  ^  from  the  cow, 

"  Mary  Payne,  3rd  day.  The  inoculated  part  elevated  and 
slightly  inflamed. 

"  6th  day.  The  local  tumour  extended  to  about  one-third 
of  an  inch  in  diameter,  and  was  nearly  of  a  circular  form,  with 
its  edges  more  elevated  than  its  centre,  and  with  the  surrounding 
inflammation  not  greater  than  is  usual  in  cases  of  inoculated 
Small  Pox.  The  vesicle  upon  the  middle  of  the  tumour  was 
now   very  large  and  distended  with  a  limpid  fluid. 

"  8th  day.  The  redness  surrounding  the  tumour  seems 
returning,  and  the  thirst  and  other  febrile  symptoms  are  much 
abated. 

"  9th  day.  She  is  perfectly  free  from  complaint  ;  the 
inoculated  part  is  scabbing,  but  surrounded  with  a  hard  tume- 
faction of  a  bright  red  colour." 


'  Vide\o\.  ii.,  p.  100. 


VACCINE  LYAIPHr  367 


Consequently  Woodville,  after  describing  two  hun- 
dred cases  of  inoculated  Cow   Pox,   wrote  : — 

"  We  have  been  told  that  the  Cow  Pox  tumour  has  frequently 
produced  erysipelatous  inflammation,  and  phagedenic  ulceration, 
but  the  inoculated  part  has  not  ulcerated  in  any  of  the  cases 
which  have  been  under  my  care,  nor  have  I  observed  inflamma- 
tion to  occasion  any  inconvenience  except  in  one  instance,  when 
it  was  soon  subdued  by  the  application  of  aqua  lithargyri  acetati." 

Similar  experiences  have  been  encountered  since,  in 
the  early  removes  of  fresh  stocks  of  virulent  lymph. 
Bousquet,^  in  1836,  in  the  first  trials  with  his  new  lymph, 
made  three  punctures,  but  he  had  soon  to  abandon 
this  practice,  because  the  intensity  of  the  inflammation 
was  sometimes  so  great  that  it  spread  over  the  arm 
and  into  the  axilla.  In  one  case,  the  vesicles  were 
enormous,  and  the  inflammation  so  violent  that  baths, 
poultices,  fomentations,  and  antiphlogistic  diet  scarcely 
sufficed  to  reduce  it.  The  crusts  when  they  fell  off,  left 
ulcerations  which  were  very  slow  to  undergo  cicatrization. 

In  some  cases,  the  vesicles  which  resulted  hollowed 
out  the  skin  so  deeply  that  they  left  7^egtiiar  Jioles? 

It  was  then  that  Bousquet  appreciated  Jenner's 
fears  {les  frayeurs  de  Jemter)  and  understood  his 
anxiety  to  suppress  the  vesicle  by  every  means  in  his 
power,   including  cauterisation. 

The    following    year,    Estlin,'    in    England,    started   a 

^    Vide  vol.  ii.,  p.  311. 

^  Compare  p.  426. 

*    Vtde  vol.  ii.,  p.  ^23. 


368  COW  POX. 

Stock  of  fresh  vaccine   virus    from    the    cow,   and    soon 
found  that  the  new  lymph  was  extremely  active. 

"Jane,  inoculated  from  the  hand  of  a  milker,  had  three  large 
fine  prominent  circular  vesicles,  and  subsequently  Estlin  learnt 
that  the  child  became  'very  poorly.'  Sarah  Owens  was  inocu- 
lated with  lymph  from  Jane. 

"  Each  vesicle  was  perfect,  rising  abruptly  from  the  arm,  its 
upper  part  almost  overhanging  the  base  ;  its  surface  was  much 
flattened,  and  it  yielded  freely  limpid  fluid,  when  punctured  before 
the  areola  appeared.  On  the  thirteenth  day,  the  child's  body  and 
extremities  were  covered  with  a  rash  in  patches  much  elevated 
from  the  skin,  and  she  was  constitutionally  indisposed.  On  the 
fifteenth  day,  the  surface  of  the  vesicle  was  becoming  brown, 
and  the  areola,   rash,  and  general  indisposition  had  disappeared." 

In  contrasting  this  new  lymph  with  the  current 
lymph,   Estlin  said  : — 

"  The  depth  in  the  cellular  membrane  to  which  the  vesicle 
extends  is  a  marked  feature  in  the  new  lymph.  In  some  cases 
under  my  care,  when  during  the  third  week  the  scab  has  been 
rubbed  off,  there  have  been  deep,  though  not  wide,  circular 
cavities,  that  would  have  contained  the  whole  of  a  pea-nut 
of  tne  smallest  size." 

Estlin's  lymph  was  employed  on  sixty-eight  children 
by  Messrs.  Michell  and  Prankard,  of  Langport  in 
Somersetshire,  and  the  results  which  they  reported  to 
Estlin  were  : — 

In   52  the  disease  was  regular. 

1  Severe  erysipelas. 

4  Erythematous  eruptions  of  a  violent  character. 

2  Highly  inflamed  ulcerated  arms. 
I   No  effect  after  twice  vaccinating. 

8  Result  unknown  ;  supposed  to  have  been  favourable. 

68 


"  VACCINE  LYMPH."  369 

In  one  of  the  patients,  two  months  old,  er)'thema 
appeared  on  the  back,  and  gradually  extended  to  the 
feet.  The  child  had  much  dyspnoea,  with  croupy  cough, 
and  died  on  the  21st,  Mr.  Estlin's  correspondent 
wrote  :  — 

"  I  do  not  attribute  its  death  to  vaccination,  nor  does  the 
mother  wholly,  as  she  lost  an  infant  previously  with  a  similar 
affection  of  the  air  passages,  but  her  neighbours  set  it  down  to 
vaccination  entirely." 

The  case  of  erysipelas,  and  two  more  cases  of 
erythema  were  serious.  The  attacks  occurred  during 
the  first  week,  two  of  them  on  the  day  following 
vaccination. 

The  alarm  caused  by  these  violent  symptoms  was 
so  great  that  Messrs.  MIchell  and  Prankard  suspended 
the  use  of  the  new  lymph. 

Estlin  supplied  some  of  his  lymph  to  the  National 
Vaccine  Establishment.  Trials  were  made,  but  details 
were  suppressed  from  publication,  from  which  we 
may  perhaps  conclude  that  in  some  instances  similar 
results  to  those  experienced  by  the  Langport  practi- 
tioners were  met  with.  The  lymph  was  condemned, 
the  practice  of  going  back  to  the  cow  was  discoun- 
tenanced, and  the  Report  insinuated  (without  mentioning 
his  name)  that  Mr.  Estlin  was  disseminating  "spurious" 
Cow   Pox. 

"  We  are  sorry  to  hear  an  anxiety  expressed  that  a  recur- 
rence should  often  be  made  to  the  disease  of  the  cow  which 
first    supplied    the    genuine    protective    matter ;    for   in    the    first 

VOL.   I.  24 


370  COW  POX. 

place  it  is  not  in  the  nature  of  any  other  communicable  virus  to 
degenerate  and  lose  its  influence  .  .  .  and  though  we  ourselves 
have  taken  a  good  opportunity  more  than  once  or  twice  of 
recruiting  our  stores  with  fresh  genuine  matter  from  the  cow, 
yet  we  think  it  right  to  discourage  an  indiscriminate,  imprudent 
resort  to  this  experiment ;  because  the  animal  is  subject  to  more 
than  one  eruptive  disease,  and  a  slight  mistake  might  possibly  be 
made  in  the  selection  of  the  proper  pustule  by  an  inexperienced 
hand." 

This  Report  received  a  severe  castigation  from  the 
pen  of  Mr.  EstHn.^  The  lymph  continued  to  be  em- 
ployed by  practitioners  all  over  this  country,  and  having 
been  mitigated  by  successive  transmission  through  the 
human  subject,  vv^as  v^elcomed  as  "a  great  boon  to  the 
public  and  profession."  It  was  also  sent  to  America 
and  other  parts  of  the  world. 

Effects   of    Inoculation   of    Mitigated 
Cow   Pox  Lymph. 

When  lymph  has  been  attenuated  or  mitigated 
by  careful  selection  and  successive  cultivation  on 
the  human  arm,  or  the  belly  of  the  calf,  it  pro- 
duces effects  which  are  as  follow : — About  the  end 
of  the  second  day  after  insertion,  or  early  on  the 
third  day,  a  slight  papular  elevation  is  noticeable. 
By  the  fifth  or  sixth  day,  it  has  become  a  distinct 
vesicle,  of  a  bluish-white  colour,  with  raised  margin 
and  central  cup-like  depression.  The  vesicle  is  perfect 
by  the  eighth  day,  and  is  then  circular,  pearl-coloured, 
distended  with  clear  lymph,  with  the  central  depression 

'  V{de  vol.  ii.,  p.  345. 


' '  VA  CCINE  L  YMPH. ' ' 


37^ 


well  marked.  On  the  same  day,  or  a  little  earlier, 
the  areola  begins  to  appear,  and  gradually  extends  to  a 
diameter  of  from  one  to  three  inches,  accompanied  with 
induration  and  tumefaction  of  the  subjacent  connective 
tissue.  After  the  tenth  day,  the  areola  begins  to  fade, 
and  the  vesicle  at  the  same  time  begins  to  dry  in  the 
centre  ;  the  lymph  becomes  opaque  and  gradually  con- 
cretes, and  by  the  fourteenth  or  fifteenth  day,  a  hard 
mahogany-coloured  scab  is  formed,  which  contracts, 
dries,  blackens,  and  falls^  off  between  the  twentieth 
and  twenty-fifth  day.  A  circular,  depressed,  foveated, 
and  sometimes  radiated,   scar  remains  behind. 

Bv  selecting  characteristic  vesicles  on  the  calf  or 
the  human  subject,  and  by  collecting  the  lymph 
at  an  early  stage  on  the  fifth,  sixth,  or  seventh  day, 
this  artificial  disease,  described  as  vaccinia,  can  be 
propagated  in  this  comparatively  mild  form.  But 
under  certain  conditions,  such  as  a  peculiarity  in  the 
subject  inoculated,  or  if  lymph  be  taken  too  late,  there 
will  be,  just  as  in  variolation,  a  tendency  to  revert  to 
the  full  intensity  of  the  natural  virus. 


CHAPTER    XIV. 

"  GREASE''   AS  A    SOURCE   OF   "  VACCINE  LYMPHr 

Jenner    included     all    spontaneous     eruptions     on    the 

teats  in  the  term   "spurious  Cow  Pox."      None  of  them 

were     capable     of     yielding    the     "grand    preventive." 

True    Cow    Pox,   as    he    designated    the    source   of  his 

"  vaccine  lymph,"  was   the  eruption   on   the  cow's   teat 

which,  according  to  a  prevalent  belief  among  farmers, 

originated    from    the    grease.       This    disease    was    thus 

briefly  described  in  Jenner's  Inquiry} 

"  There  is  a  disease  to  which  the  Horse  from  his  state  of 
domestication  is  frequently  subject.  The  Farriers  have  termed 
it  i/ic  Grease.  It  is  an  inflammation  and  swelling  in  the  heel, 
accompanied  at  its  commencement  with  small  cracks  and 
fissures,  from  which  issues  matter  possessing  properties  of  a 
very  peculiar  kind." 

If  the  men  who  dressed  the  horses'  heels  were 
called  upon  to  milk  cows,  they  communicated  to  them 
the   malady  known  as  the  Cow   Pox. 

In    support   of  these    statements    several    cases    were 

given. 

Case  I.  Several  horses  belonging  to  a  farm  began  to  have 
sore-heels,  which   a  man  named  Merret  attended  to.     He  milked 

^  Vide  vol.  ii.,  p.  7. 


VACCINE  LYMPHr  373 


:the   cows.      They    soon    became    affected    with    Cow    Pox,    and 

several  sores  appeared  on  his  hands. 

Case  2.  One  of  the  horses  on  a  farm  had  soir-heels,  and  it 
•fell  to  the  lot  of  William  Smith  to  attend  to  the  animal.  By 
:  these  means  the  infection  was    carried    to    the    cows,    and    from 

the  cows  it  was  communicated  to  Smith.     On  one  of  his  hands 

were    several    ulcerated   sores,    and    he    was    affected    with   such 

symptoms  as  have  been  before  described. 

Case  3.    Simon   Nicholls   was  employed  in  applying  dressings 

to  the  sore-heels  of  one  of  his  master's  horses,  and  at  the  same 
I  time  milked    his  master's    cows.       The  cows   became  affected  in 

consequence,  though  not  until  several  weeks  after  he  had  begun 

to  dress  the  horse. 

Case  4.  A  mare,  the  property  of  a  dairy  farmer,  began  to 
I  have  sore-heels,  which  were  occasionally  washed   by  the  servant 

men  of  the  farm, — Thomas  Virgoe,  William  Wherret,  and 
'William  Haynes.  They  contracted  "sores  on  their  hands,  fol- 
I  lowed  by  inflamed  lymphatic  glands  in  the  arms  and  axillae, 
ishiverings  succeeded  by  heat,  lassitude  and  general  pains  in  the 
1  limbs;"  and  the  disease  was  also  communicated  to  the  cows. 

From  another  case  in  his  experience,  Jenner  thought 
;it  highly  probable  that  not  only  the  heels  of  the  horse, 
I  but  other  parts  of  the  body  of  that  animal,  were 
capable  of  yielding  the  virus  which  produces  Cow  Pox. 

"' An  extensive  inflammation  of  the  erysipelatous  kind  appeared 
without  any  cause  upon  the  upper  part  of  the  thigh  of  a 
sucking  colt.  .  .  .  The  inflammation  continued  several  weeks,  and 
at  length  terminated  in  the  formation  of  three  or  four  small 
abscesses.'  Dressings  were  applied  to  the  colt  by  those  who 
milked  the  cows,  and  all  of  them  had  Cow  Pox." 

When  Woodville  discovered  Cow  Pox,  and  raised 
a  stock  of  "vaccine  lymph,"  it  was  the  ordinary  "spon- 
taneous "   Cow   Pox,  arising  quite  independendy  of  any 


374 


grease:' 


disease  of  the  horse's  heels.  Jenner  nevertheless  pro- 
nounced the  vaccine  to  be  genuine,  and  abandoned  for 
a  while,  the  horse-grease  theory.  In  An  Account  of  the 
Origin  of  the  Vaccine  Inoculation}  and  in  his  evidence 
before  the  Committee  of  the  House  of  Commons,  he 
omitted  any  reference  whatever  to  this  malady. 

Thus  when  Jenner  had  published  his  famous  Inquiry, 
he  found  that  grease,  transmitted  direct  to  man,  wasi 
not  protective  against  Small  Pox.  In  one  case,  Small 
Pox  was  produced  by  inoculation,  and  in  another,  by, 
infection,  after  an  attack  of  grease.  To  explain  this, 
Jenner  assumed  that  the  virus  from  the  horse's  heel 
must  be  modified  by  passage  through  the  cow  in 
order  to  acquire  the  peculiar  properties  which  converted 
it  into  a  protective  against  Small  Pox.  Later  he 
abandoned  horse  grease  altogether  and  advocated 
"  spontaneous "  Cow  Pox,  but  still  later  he  reverted 
to  grease,  and  formally  adopted  it  as  the  "true  life- 
preserving  fluid."  ^ 

Jenner  recognised  tha  this  vaccinogenic  "grease" 
was  not  limited  to  the  heels  of  the  horse.  The  fullest 
description  which  he  wrote  of  the  disease  was  the 
following  : — 

"  The  skin  of  the  horse  is  subject  to  an  eruptive  disease  of 
a  vesicular  character,  which  vesicle  contains  a  limpid  fluid, 
showing  itself  most  commonly  in  the  heels.  The  legs  first 
become  cedematous ;  and  then  fissures  are  observed.  The  skin 
contiguous  to  these  fissures,  when  accurately  examined,  is  seen 

'  Vide  vol.  ii.,  p.  271.  ^  p.  393. 


"  VACCINE  lymph: 


375 


studded  with  small  vesicles  surrounded  by  an  areola.  These 
vesicles  contain  the  specific  fluid.  It  is  the  ill  management 
of  the  horse  in  the  stable  that  occasions  the  malady  to  appear 
more  frequently  in  the  heel  than  in  other  parts ;  I  have  detected 
it  connected  with  a  sore  on  the  neck  of  the  horse,  and  on  the 
thigh  of  a  colt." 

According  to  Baron,  Jenner  had  observed  a  case  of 
transmission  of  grease  to  sheep  : — 

"  Dr.  Jenner,  in  like  manner,  had  ascertained  that  the  cow 
was  not  the  only  animal  capable  of  receiving  the  infection  of 
the  grease.  A  sheep  that  had  three  lambs,  of  which  two 
perished,  being  incommoded  by  the  superabundance  of  milk, 
was  drawn  by  a  servant  w^ho,  at  the  same  time,  dressed  the 
greasy  heels  of  a  horse.  Pustules,  similar  to  those  of  the 
Vaccine,  appeared  on  the  teats  of  the  sheep  :  the  same  person 
who  milked  the  sheep  immediately  afterwards  milked  two  cows, 
and  communicated  the  disease  to  them.  From  the  cows  thus 
infected  a  servant  of  the  house  received  the  Cow  Pox." 

Jenner  summed  up  his  reasons  for  attributing  Cow 
Pox  to  grease  as  follov^s  : — 

"  First.  I  conceived  this  was  its  source,  from  observing  that 
where  the  Cow  Pox  had  appeared  among  the  dairies  here  (unless 
it  could  be  traced  to  the  introduction  of  an  infected  cow  or 
servant)  it  had  been  preceded  at  the  farm  by  a  horse  diseased 
in  the  manner  already  described,  which  horse  had  been  attended 
by   some   of  the   milkers. 

"  Secondly.  From  its  being  a  popular  opinion  throughout 
this  great  dairy  countr}-,  and  from  its  being  insisted  on  by 
those  who  here  attend  sick  cattle. 

"Thirdly.  From  the  total  absence  of  the  disease  in  those 
countries,  where  the  men  servants  are  not  employed  in  the  dairies. 

"  Fourthly.  From  having  observed  that  morbid  matter 
generated  by  the  horse  frequently  communicates,  in  a  casual 
way,  a  disease  to  the  human  subject  so  like  the  Cow  Pox,  that 


376  "GREASE:' 


in  many  cases  it  would  be  difficult  to  make  the  distinction 
between  one  and  the  other. 

"  Fifthly.  From  being  induced  to  suppose,  from  experiments, 
that  some  of  those  who  had  been  thus  affected  from  the  horse 
resisted  the  Small  Pox. 

"Sixthly.  From  the  progress  and  general  appearance  of  the 
pustule  on  the  arm  of  the  boy  whom  I  inoculated  with  matter 
taken  from  the  hand  of  a  man  infected  by  a  horse  ;  and  from 
the  similarity  to  the  Cow  Pox  of  the  general  constitutional 
symptoms  which  followed." 

Baron  has  published  Jenner's  reasons  from  MS.  notes, 
which  contain  several  important  additional  details. 

"  1st.  From  its  being  the  fixed  opinion  of  those  who  have 
been  in  the  habit  of  attending  to  cows  infected  with  this  disease 
for  a  great  number  of  years. 

"  2ndly.  From  its  being  a  popular  opinion  in  this  great 
dairy-country,  and  from  the  cautions  the  farmer  observes  when 
he   has  a  horse    with   a  sore  heel. 

"  3rdly.  From  observing,  in  almost  every  instance,  that  the 
appearance  of  the  Cow  Pox  at  a  farm  was  preceded  by  some 
disease  of  a  horse  at  the  same  farm,  which  produced  the  dis- 
charge of  some  fluid  from   the  skin. 

"4thly.  From  having  attempted,  in  vain,  to  give  the  Small 
Pox  to  the  son  of  a  farrier  who  had  had  sores  and  a  fever, 
from  dressing  a  diseased  horse. 

"And  5thly.  From  the  peculiar  appearance  of  the  pustule, 
and  its  disposition  to  run  into  an  ulcer  in  the  arm  of  the  boy 
who  was  inoculated  with  matter  taken  from  the  hand  of  a 
man  who  received  the  infection  from  dressing  a  slight  spon- 
taneous sore  on  a  horse's  heel." 

in  testimony  of  its  being  a  popular  opinion,  Jenner 
published  a  letter  on  this  subject  from  the  Rev.  Mr. 
Moore,  of  Chalford  Hill  •}— 

^  Vide  vol.  ii.,  p.  169. 


VACCINE  LYMPH."  7,17 


"  In  the  month  of  November,  1797,  my  horse  had  diseased 
heels,  which  was  certainly  what  is  termed  the  grease ;  and  at 
a  short  subsequent  period  my  cow  was  also  afifected  with  what 
a  neighbouring  farmer  (who  was  conversant  with  the  complaints 
of  cattle)  pronounced  to  be  the  Cow  Pox,  which  he  at  the 
same  time  observed  my  servant  would  be  infected  with  :  and 
this  proved  to  be  the  case  ;  for  he  had  eruptions  on  his  hands, 
face,  and  many  parts  of  the  body,  the  pustules  appearing 
large,  and  not  much  unlike  the  Small  Pox,  for  which  he  had 
been  inoculated  a  year  and  a  half  before,  and  had  then  a  very 
heavy  burthen.  The  pustules  on  the  face  might  arise  from 
contact  with  his  hands,  as  he  had  a  habit  of  rubbing  his 
forehead,  where  the  sores  were  the  largest  and  thickest. 

"The  boy  associated  with  the  farmer's  sons  during  the 
continuance  of  the  disease,  neither  of  whom  had  had  the  Small 
Pox,  but  they  felt  no  ill  effects  whatever.  He  was  not  much 
indisposed,  as  the  disease  did  not  prevent  him  from  following 
his  occupations  as  usual.  No  other  person  attended  the  horse 
or  milked  the  cow,  but  the  lad  above  mentioned.  I  am  firmly 
of  opinion  that  the  disease  in  the  heels  of  the  horse,  which 
was  a  virulent  grease,  was  the  origin  of  the  servant's  and 
the  cow's  malad}'." 

Jenner  remarks  : — 

"  From  the  similarity  of  symptoms,  both  constitutional  and 
local,  between  the  Cow  Pox  and  the  disease  received  from 
morbid  matter  generated  by  a  horse,  the  common  people  in 
this  neighbourhood,  when  infected  with  this  disease,  through 
a  strange  perversion  of  terms,  frequently  called  the  Cow  Pox. 
Let  us  suppose  then  such  a  malad}^  to  appear  among  some 
of  the  servants  at  a  farm,  and  at  the  same  time  that  the  Cow 
Pox  were  to  break  out  among  the  cattle ;  and  let  us  suppose 
too  that  some  of  the  servants  were  infected  in  this  way,  and 
that  others  received  the  infection  from  the  cows.  It  would 
be  recorded  at  the  farm,  and  among  the  servants  themselves, 
wherever  they  might  afterwards  be  dispersed,  that  they  had 
all  had  the   Cow   Pox.      But  it  is  clear  that   an    individual   thus 


378  ''GREASE." 


infected  from  the  horse  would  neither  be  for  a  certainty  secure 
himself,  nor  would  he  impart  security  to  others,  were  they 
inoculated  by  virus  thus  generated.  He  still  would  be  in 
danger  of  taking  the  Small  Pox.  Yet  were  this  to  happen 
before  the  nature  of  the  Cow  Pox  be  more  maturely  considered 
by  the  public,  my  evidence  on  the  subject  might  be  depreciated 
unjustly." 

Jenner     also     received    the    following    account^    from 

Mr.    Fewster,   of    Thornbury,    "a   gentleman   perfectly 

well     acquainted     with    the    appearances    of   the    Cow 

Pox    on    the    human    subject:" — 

"  William  Morris,  aged  thirty-two,  servant  to  Mr.  Cox  of 
Almonsbury,  in  this  county,  applied  to  me  the  2nd  of  April, 
1798.  He  told  me,  that  four  days  before  he  found  a  stiffness 
and  swelling  in  both  his  hands,  which  were  so  painful,  it 
was  with  difficulty  he  continued  his  work ;  that  he  had  been 
seized  with  pain  in  his  head,  small  of  the  back,  and  limbs, 
and  with  frequent  chilly  fits  succeeded  by  fever.  On  examina- 
tion I  found  him  still  affected  with  these  symptoms,  and  that 
there  was  a  great  prostration  of  strength.  Many  parts  of  his 
hands  on  the  inside  were  chapped,  and  on  the  middle  joint  of 
the  thumb  of  the  right  hand  there  was  a  small  phagedenic 
ulcer,  about  the  size  of  a  large  pea,  discharging  an  ichorous 
fluid.  On  the  middle  finger  of  the  same  hand  there  was 
another  ulcer  of  a  similar  kind.  These  sores  were  of  a  circular 
form,  and  he  described  their  first  appearance  as  being  some- 
what like  blisters  arising  from  a  burn.  He  complained  of 
excessive  pain,  which  extended  up  his  arm  into  the  axilla. 
These  symptoms  and  appearances  of  the  sores  were  so  exactly 
like  the  Cow  Pox,  that  I  pronounced  he  had  taken  the  distemper 
from  milking  cows.  He  assured  me  he  had  not  milked  a  cow 
for  more  than  half  a  year,  and  that  his  master's  cows  had 
nothing  the  matter  with  them.  I  then  asked  him  if  his  master 
had    a  greasy    horse  ?    which    he    answered    in    the    affirmative ; 

^  Vide  vol.  ii.,  p.  170. 


VACCINE  lymph: 


379 


and  further  said,  that  he  had  constantly  dressed  him  twice 
a  day  for  the  last  three  weeks  or  more,  and  remarked  that  the 
smell  of  his  hands  was  much  like  that  of  the  horse's  heels. 
On  the  5th  of  April,  I  again  saw  him,  and  found  him  still 
complaining  of  pain  in  both  his  hands,  nor  were  his  febrile 
symptoms  at  all  relieved.  The  ulcers  had  now  spread  to  the 
size  of  a  seven-shilling  gold  coin,  and  another  ulcer,  which  I  had 
not  noticed  before,  appeared  on  the  first  joint  of  the  fore- 
finger of  the  left  hand,  equally  painful  with  that  on  the  right. 
I  ordered  him  to  bathe  his  hands  in  warm  bran  and  water, 
applied  escharotics  to  the  ulcers,  and  wrapped  his  hands  up 
in  a  soft  cataplasm.  The  next  day  he  was  much  relieved,  and 
in  something  more  than  a  fortnight  got  well.  He  lost  his  nails 
from   the  thumb  and  fingers  that  were  ulcerated." 

Mr.  Tanner  was  the  first  to  succeed  in  experiment- 
ally transmitting  grease  to  the  cow  by  inoculating 
some  of  the  liquid  matter  from  the  heel  of  a  horse. 
The  result  was  the  production  of  a  "  vaccinal  vesicle," 
and  he  wrote  : — 

"  From  handling  the  cow's  teats,  I  became  infected  myself, 
and  had  two  pustules  on  my  hand,  which  brought  on  inflammation 
and  made  me  unwell  for  several  days.  The  matter  from  the 
cow  and  from  my  own  hand  proved  efficacious  in  infecting 
both  human  subjects  and  cattle." 

jenner  received  some  of  Tanner's  equine  virus  while 
he  was  in  London,  in  April  1800,  and  some  of  it,  he 
passed  on  to  Mr.  Wachsel  of  the   Small   Pox   Hospital. 

In  the  same  month  some  observations  tending  to 
confirm  Jenner's  opinion  were  made  by  Mr.  Lupton, 
a  surgeon  of  Thame,  Oxfordshire,  which  were  com- 
municated to  Jenner  by  Sir  Christopher  Pegge,  and 
published  in  the  Medical  and  Physical  Journal. 


38o  "  GREASE." 

In  the  year  1801,  Dr.  Loy  published  his  experiments 
in  a  work  entitled  Some  Observations  on  the  Origin  of 
Cow  Pox}  Coleman,  Woodville,  and  Simmons  had 
negative  results  when  they  experimented  on  cows, 
with  grease,  but  Dr.  John  Loy  met  with  very  differ- 
ent experience.  Mr.  Loy,  surgeon  at  Pickering,  had 
undertaken  experiments  from  having  met  with  the 
following  cases  : — 

"LA  farrier  applied  to  him  with  an  eruption  on  his  hands, 
composed  of  distinct  pustules,  containing  a  thin  fluid,  and  sur- 
rounded by  an  inflamed  ring.  The  vesicle  had  an  appearance 
similar  to  that  arising  from  a  burn.  They  were  all  regularly  cir- 
cumscribed, and  a  small  dark  speck  could  be  discovered  in  the 
middle  of  each.  The  patient  had  been  dressing  a  horse  affected 
with  the  grease.      He  had  had  Small   Pox. 

"II.  A  young  man,  a  butcher,  at  Middleton,  near  Pickering,  was 
affected  with  painful  sores  on  both  his  hands,  particularly  about 
the  roots  of  the  nails.  These  sores  in  a  few  days  became  inflamed, 
and  a  vesicle  formed  upon  each.  Soon  after  the  appearance  of 
the  vesicles,  a  number  of  red  painful  lines,  which  appeared  to  be 
inflamed  lymphatics  extended  from  the  pustules  to  the  arm-pit, 
where  a  tumor  formed ;  he  had  also  a  pustule,  of  the  same 
appearance  as  those  on  his  hands,  upon  one  eyebrow,  which,  he 
said,  had  been  affected  with  an  itching,  inducing  him  frequently 
to  scratch  it ;  and  the  pustule  had  no  doubt  been  communicated  in 
that  manner  from  his  fingers.  He  had  a  considerable  degree  of 
fever,  which  continued  obstinate  till  the  absorption  from  the 
pustules  was  prevented  by  destroying  them  with  caustic,  when  the 
tumor  in  the  axilla  also  dispersed.  This  patient,  like  the  former, 
had  been  for  some  time  employed  in  applying  remedies  to  the  heels 
of  a  horse  afilected  with  the  grease,  and  was  continuing  to  do  so 
at  the  time  he  begun  to  be  indisposed.  He  had  never  undergone 
the  Small  Pox." 

^   Vide  vol.  ii.,  p.  2-9. 


"  VACCINE  LYMPHr  381 


Mr.  Loy,  beincr  curious  to  ascertain  whether  this  dis- 
ease could  be  communicated  by  inoculation,  took  a 
quantity  of  matter  from  the  pustules  of  this  patient 
and  inserted  it  into  the  arm  of  his  brother,  with  the 
following  results  : — 

"  In  a  few  days,  some  degree  of  inflammation  appeared,  and  on 
the  eighth  day,  a  vesicle  formed  ;  my  patient  had  now  some  slight 
feverish  symptoms,  which  continued  a  day  or  two. 

"  This  disease  had  exactly  the  appearances  of  the  genuine  Cow 
Pox,  and  1  intended  to  have  tried  the  effect  of  the  Small  Pox  virus, 
had  not  the  fears  of  the  boy's  parents  prevented  me." 

At  the  same  time  that  Mr.  Loy  performed  this 
experiment,  Dr.  John  Loy  inoculated  the  udder  of  a 
cow  with  matter  from  the  pustule  of  the  same  patient. 
When  the  animal  was  inspected  on  the  ninth  day,  there 
was  a  vesicle  with  a  "  rose-coloured  rim."  Matter  was 
taken  and  inserted  into  the  arm  of  a  child.  The 
inflammation,  vesication,  and  scabbing  which  followed 
corresponded  with  Cow  Pox.  On  the  sixth  day  of 
the  disease,  the  child  was  inoculated  with  Small  Pox. 
The  wound  "  seemed  to  be  rather  inflamed  on  the 
third  day,  but  in  a  few  days  more  it  healed." 

Dr.  Loy  then  inoculated  another  child,  with  matter 
taken  direct  from  Mr.  Loy's  patient.  The  results 
were  similar  to  the  effects  of  Cow  Pox,  and  subse- 
quent inoculation  of  Small  Pox  produced  no  effect. 
The  next  experiment  was  with  another  case  of  grease. 
A  cow  was  inoculated,  and  in  a  few  days,  a  vesicle 
formed     containing    a    large    quantity    of  watery    fluid, 


382  ''GREASE:' 


and  of  a  purple  tinge.  A  quantity  of  the  limpid 
water  was  inserted  into  the  arm  of  a  child.  A  vesicle 
formed  on  the  ninth  day,  and  the  same  day,  the  child 
was  inoculated  with   Small   Pox  without  effect. 

Ur.  John  Loy  then  inoculated  a  child  direct  from  a 
horse  suffering  from  grease. 

"  On  the  third  day,  a  small  degree  of  inflammation  surrounded 
the  wound.  On  the  fourth,  the  inoculated  place  was  much  elevated, 
and  a  vesicle,  of  a  purple  colour,  was  formed  on  the  fifth  day  :  on 
the  sixth  and  seventh,  the  vesicle  increased,  and  the  inflammation 
extended,  and  became  of  a  deeper  colour ;  on  the  same  day,  a  chilli- 
ness came  on,  attended  with  nausea  and  some  vomiting.  These 
were  soon  succeeded  by  increased  heat,  pain  in  the  head,  and  a 
frequency  of  breathing  ;  the  pulse  was  very  frequent,  and  the 
tongue  was  covered  with  a  white  crust.  When  in  bed,  the  child 
was  much  disposed  to  sweat.  By  the  use  of  some  medicines,  and 
exposure  to  cool  air,  the  feverish  symptoms  soon  abated,  and  dis- 
appeared entirely  on  the  ninth  day.  On  the  sixth  day.  Small  Pox 
matter  was  inserted  into  the  same  arm  in  which  the  matter  of 
Grease  had  been  placed,  but  at  a  considerable  distance  from  it. 
On  the  fourth  and  fifth  days  of  the  Small  Pox  inoculation,  some 
redness  appeared  about  the  wound,  and  on  the  sixth  a  small 
vesicle.  The  inflammation  now  decreased,  and  on  the  ninth  day, 
the  vesicle  was  converted  into  a  scab." 

On  the  sixth  day  of  the  inoculation,  four  other  chil- 
dren were  inoculated  with  matter  from  this  child.  On 
the  tenth  day,  an  extensive  erysipelatous  efflorescence 
surrounded  the  vesicles.  On  the  same  day,  they  were 
all  inoculated  for  the  Small  Pox,  in  the  arms  free  from 
the  former  inoculation.  Nothing  appeared  except  a 
very  small  degree  of  inflammation.  It  is  not  stated 
whether  the  lymph  stock  was  carried  on. 


VAC  CIA' E  lymph:'  383 


PEDIGREE  OF   THE   FIRST   STOCK   OF   DIRECT 
EQUINE   LYMPH. 

HORSK 

A  Child 
Five  Children 

Loy  had  made  a  number  of  experiments  with  grease, 
but  only  in  certain  cases  did  he  succeed  in  getting  posi- 
tive results,  for  which  he  gave  the  following  reason  : — 

"  This  fact  induces  me  to  suspect,  that  two  kinds  of  Grease 
exist,  differing  from  each  other  in  the  power  of  giving  disease  to 
the  human  or  brute  animal  ;  and  there  is  another  circumstance 
which  renders  this  supposition  probable.  The  horses  that  com- 
municated the  infection  to  their  dressers  were  affected  with  a 
general,  as  well  as  a  topical  disease.  The  animals,  at  the  com- 
mencement of  their  disease,  were  evidently  in  a  feverish  state, 
from  which  they  were  relieved  as  soon  as  the  complaint  appeared 
at  their  heels,  and  an  eruption  upon  the  skin.  The  horse,  too, 
from  whom  the  infectious  matter  was  procured  for  inoculation, 
had  a  considerable  indisposition,  previous  to  the  disease  at  his 
heels,  which  was  attended,  as  in  the  others,  with  an  eruption  over 
the  greatest  part  of  his  body;  but  those  that  did  not  communicate 
the  disease  at  all,  had  a  local  affection  only.  From  this,  perhaps, 
may  be  explained,  the  want  of  success  attending  the  experiments 
of  the  gentlemen  I  have  mentioned." 

Loy  also  observed  that  the  grease  appeared  to  act 
with  greater  mildness  after  having  been  cultivated  on 
the  cow,  or  the  human  subject.  Thus  after  direct 
inoculation  from  the  horse,  a  purple  tinge  was  ob- 
served, but  this  did  not  appear  with  lymph  which  had 
been  passed  either  through  the  medium  of  the  cow  or 
the  human  subject. 


384  "  GREASEr 

With  regard  to  the  appHcation  of  the  variolous  test, 
all  Loy's  experiments  were  deprived  of  any  value.  No 
conclusions  could  be  drawn  when  the  inoculation  was 
performed  at  or  near  the  height  of  the  disease,  which 
had  been  produced  by  insertion  of  the  virus  of  grease. 
Loy  ought  to  have  been  fully  aware  that  under  such 
circumstances,  inoculation  would  prove  abortive. 

Jenner  was  the  first  to  perform  arm-to-arm  indirect, 
and  Loy  was  the  first  to  perform  arm-to-arm  direct 
equination. 

Jenner  sent  a  copy  of  Loy's  work  to  the  Duke  of 
Clarence  with  a  letter,  in  which  he  made  the  following 
remarks  : — 

"  In  obedience  to  the  wish  your  Royal  Highness  expressed  to 
me  at  Lord  Grantley's,  I  have  done  myself  the  honour  of  sending 
you  Dr.  Loy's  pamphlet  on  the  Origin  of  the  Cow  Pox,  which 
decisively  proves  my  early  assertions  upon  that  subject.  This 
discovery  is  the  more  curious  and  interesting  as  it  places  in  a 
new  point  of  view  the  traditionary  account  handed  down  to  us 
by  the  Arabian  physicians  that  the  Small  Pox  was  originally 
derived  from  the  camel.  The  whole  opens  to  the  physiologist 
a  new  field  of  inquiry,  and  I  sincerely  hope  it  may  be  so  cul- 
tivated that  human  nature  may  reap  from  it  the  most  essential 
benefit." 

Dr.  Loy  also  corresponded  with  Jenner  on  this 
subject. 

Dr.   Loy  to  Dr.  Jenner. 

"Sir, — I  have  not  yet  had  an  opportunity  of  making  any 
further  experiments  respecting  the  origin  of  the  Cow  Pox,  on 
account  of  the  disease  of  grease  having  been  of  late  remarkably 


VACCINE  LYMPH r  385 


rare  in  this  country.  From  the  evidence,  however,  I  have  had 
of  the  truth  of  your  opinion,  and  from  some  observations  which 
have  been  made  on  my  experiments  by  my  worthy  preceptor,  Dr. 
Duncan,  of  Edinburgh,  I  consider  myself  in  some  degree  called 
upon  to  pay  more  attention  to  this  curious  subject,  and  you  may, 
Sir,  be  assured  that  you  shall  be  informed  of  my  success. 

"  I  have  the  satisfaction  to  mention  that  the  subject  inoculated 
with  the  grease  matter  on  Experiment  VI.  has  withstood  the  action 
of  the  Small  Pox,  by  way  of  repeated  exposure  to  the  natural 
disease.  Several  of  those  also  who  were  inoculated  with  vaccine 
virus,  generated  by  inoculation  with  the  equine,  have  been  exposed 
more  than  once  to  the  natural  infection  of  the  Small  Pox,  but 
without  the  least  effect.  Dr.  Duncan  seems  to  conjecture  that  the 
persons  on  whom  the  experiments  were  performed  might  have 
previously  had  the  small  Pox ;  but  any  foundation  for  such  a 
supposition  is  perfectly  groundless.  Most  of  the  persons  who 
were  subjected  to  the  experiments  had  never  been  within  several 
miles  of  the  Small  Pox  till  inoculated.  And  that  the  small  Pox 
matter  I  made  use  of  was  good  is  proved  by  the  same  virus 
giving  readily  the  disease  to  others. 

"  There  is  not  the  least  doubt  but  the  experiments  will  remain 
successful ;  and  that  they  were  fairly  performed  many  respectable 
gentlemen  in  this  neighbourhood  can  testify.  One  gentleman  at 
my  request  saw  me  inoculate  one  of  his  cows  from  the  greased 
heels  of  his  horse,  with  a  lancet  which  he  himself  supplied  me  at 
the  time  of  experiment.  This  trial  was  successful.  .  .  . 
"  Give  me,  Sir,  the  honour  to  subscribe  myself, 

"  Your  faithful  friend  and  servant, 

"  John  Glover  Loy. 

"  Whitby,  December  ztfh,  1802." 

Experiments  with  grease  were  also  made,  about  this 
time,  on  the  Continent.  Dr.  De  Carro  appears  to 
have  been  the  first  to  communicate  to  Jenner  the  result 
of  some  experiments  conducted  by  Sacco. 

VOL.  I.  25 


386  "  grease:' 

"If  you  have  felt  so  much  pleasure  in  hearing  that  your 
discovery  is  known  and  practised  in  India,  I  hope  that  my  lat^ 
intelligence  of  the  true  Cow  Pox,  produced  at  Milan  with  the 
giardorii  on  Dr.  Sacco's  own  horse  and  that  of  one  of  his  neigh- 
bours,  has  not  been  less  agreeable  to  you." 

And  in  a  reply  to  his  letter  Jenner  makes  some 
observations  on  this  subject. 

Dr.  Jenner  to  Dr.   De  Carro. 

"  March  2^th,  1803. 

"  Since  the  commencement  of  our  correspondence,  great  as  my 
satisfaction  has  been  in  the  perusal  of  your  letters,  I  do  not 
recollect  when  3^ou  have  favoured  me  with  one  that  has  afforded 
me  pleasure  equal  to  the  last.  The  regret  I  have  experienced,  at 
finding  that  every  endeavour  to  send  the  vaccine  virus  to  India  in 
perfection,  again  and  again  failed,  is  scarcely  to  be  described  to 
you;  judge,  then,  what  pleasure  you  convey  in  assuring  me  that 
my  wishes  are  accomplished.  I  am  confident  that  had  not  the 
opponents,  in  this  country,  to  my  ideas  of  the  origin  of  the  disease 
been  so  absurdly  clamorous  (particularly  the  par  nobile  fratrunt) 
the  Asiatics  would  long  since  have  enjoyed  the  blessings  of  vacci- 
nation, and  many  a  victim  been  rescued  from  an  untimely  grave. 
The  decisive  experiments  of  Dr.  Loy  on  this  subject  have  silenced 
the  tongue  of  these  gentlemen  for  ever. 

"  I  am  happy  to  see  this  interesting  work  translated  by  you, 
and  hope  it  will  travel  the  world  over. 

"  It  is  very  extraordinary,  but  certainly  a  fact,  that  the  plate 
which  I  gave  in  my  first  publication  of  the  equine  pustule 
(although  its  origin  was  detailed)  was  by  almost  every  reader 
considered  as  the  vaccine.  There  are  probably  some  varieties  in 
the  pustules  which  arise  among  horses.  You  will  observe,  by  a 
reference  to  my  publication,  that  the  virus  in  the  instance  I  now 
allude  to,  was  so  very  active  that  it  infected  every  person  who 
dressed  the  horse. 

"  I  am  happy  to  find  an  opinion  taken  up  by  me,  and  mentioned 
in   my  first  publication,   has  so  able  a  supporter  as  yourself      I 


' '  VA  CCINE  L  YMFH. ' '  387 


thought  it  highly  probable  that  the  Small  Pox  might  be  a  malig- 
nant variety  of  the  Cow  Pox.  But  this  idea  was  scouted  by  my 
countrymen,  particularly  P.  and  W.  .  .  ." 

In  a  subsequent  letter,  De  Carro  gave  an  account  of 
some  important  experiments  by   Dr.   La  Font. 

De  Carro  to  Dr.  Jenner. 

"Vienna,  2isf  June,  1803. 

"  My  dear  Sir, — My  friend  Dr.  Marcet  wrote  to  me  lately 
that  the  accounts  I  have  sent  to  you  of  Dr.  Sacco's  experiments 
have  afforded  you  great  satisfaction.  The  motive  which  induces 
me  to  write  to  you  to-day  is  another  confirmation  of  your  theory 
which  has  taken  place  in  a  country  where  you  scarcely  expect 
it  from,  the  more  so  that  it  is  accompanied  with  veterinary 
observations  which  appear  to  me  v^ery  nice  and  curious. 

"  Monsieur  La  Font,  a  French  physician  established  at  Salonica 
in  Macedonia,  has  been  one  of  the  most  active  vaccinators  I  know 
on  the  continent  .  .  .  Some  time  afterwards,  I  sent  him  a 
translation  of  Dr.  Loy's  experiments,  and  desired  him  to  make 
as  many  veterinary  observations  and  experiments  as  he  could. 
He  has  some  reason  to  suppose  that  the  Cow  Pox  reigns  in  that 
country,  according  to  the  report  of  several  Albanese  peasants. 
As  to  the  grease  (which  he  calls  javart),  he  says  that  the  farriers 
at  Salonica  know  it  very  well.  Dr.  La  Font  began  his  experi- 
ments with  the  kind  of  grease  which  the  Macedonian  farriers 
call  the  variolous.  He  found  a  horse  which  had  been  attacked 
with  feverish  symptoms,  that  ceased  as  soon  as  the  eruption 
appeared.  The  fore  legs  were  much  swelled;  the  left  had  four 
ulcers,  one  upon  the  heel,  a  second  some  inches  higher,  a  third 
on  the  articulation,  a  fourth  near  the  breast.  The  eruption  on 
the  legs  was,  he  says,  very  like  the  Small  Pox,  but  none  was 
to  be  seen  on  the  other  parts  of  the  body.  He  took  matter 
from  the  upper  ulcer,  which  was  of  twelve  days'  standing.  The 
matter  was  limpid,  but  a  little  yellowish  and  fi/amentous  (thready); 
first,  a  cow  was  submitted  to  this  inoculation,  but  without  success ; 
secondly,   a  girl   twelve  years   old,    without  effect ;    but  this   girl 


388  ^' GREASE r 

had  been  vaccinated  some  months  before  without  success,  and 
was  suspected  to  have  had  the  Small  Pox ;  thirdly,  two  boys, 
one  six,  the  other  five,  years  old,  were  inoculated  with  the  same 
equine  matter  ;  and  in  both,  a  pustule  appeared,  which  followed 
the  regular  course  of  a  vaccine  pustule.  The  colour  was  less 
white,  and  more  purple  than  usual.  Those  two  children  had 
a  pretty  strong  fever,  for  which  some  cooling  medicines  were 
administered.  Those  inoculated  with  matter  from  them  under- 
went the  disease  in   its  usual  mild  way. 

■'These  particulars,  I  hope,  will  silence  all  those  who  still 
doubt  of  the  truth  of  your  doctrine.  These  observations  enhance 
the  merit  of  your  discovery.  The  means  of  making  it  were 
everywhere  ;  yet  nobody  before  you  had  the  least  idea  of  that 
singular  connection  between  the  grease,  the  Cow  Pox,  and  the 
Small   Pox." 

On  March  25th,  1803,  Sacco  communicated  to 
Jenner  the  details  of  his  experiments. 

"  1  have  for  a  long  time  been  making  experiments  with  grease 
in  order  to  confirm  your  opinion  of  the  origin  of  vaccine.  Until 
the  beginning  of  this  year,  I  have  had  only  negative  results. 
Studying  Mr.  Loy's  little  book  encouraged  me  to  make  another 
attempt.  In  the  winter  of  this  year  grease  could  not  have  been 
more  common  than  it  was,  in  consequence  of  the  quantity  of 
water  which  there  was  and  the  mud  which  resulted  on  the  roads  ; 
thus  nearly  all  the  horses  suffered  from  grease,  my  servant 
was  attacked  by  it  on  both  forearms,  having  five  vesicles  from 
dressing  one  of  my  horses  suffering  from  grease.  He  only 
informed  me  of  it  when  the  vesicles  were  beginning  to  dry  up. 
This  encouraged  me  to  continue  my  experiments.  I  inoculated 
several  children  and  several  cows  with  the  virus  which  came 
from  grease  at  different  stages,  but  always  without  effect.  A 
coachman  came  to  the  hospital  to  be  examined  with  an  eruption 
which  he  had  on  his  hands ;  it  was  at  once  recognised  that 
it  was  vaccine  taken  while  treating  horses,  which  in  fact  he  had 
dressed.  He  was  taken  to  the  foundling  hospital,  where  some 
inoculations  were  made.      He    came    to  me  the   same    day,   and 


VACCINE  LYiMPHr  389 


1  made  nine  inoculations  on  as  many  children,  and  I  inoculated 
the  teat  of  a  cow  as  well.  Three  of  these  children  had  an 
eruption  exactly  like  Cow  Pox.  Nothing  happened  in  the  cow. 
I  made  other  inoculations  with  matter  taken  from  these  children, 
and  I  have  already  reached  the  fourth  remove,  which  reproduces 
itself  with  the  same  effect  as  vaccine.  I  have  already  inoculated 
several  of  these  individuals  with  Small  Pox,  but  without  any 
effect.  It  is  therefore  very  certain  that  the  grease  is  the  cause 
of  Cow  Pox,  and  the  name  may  at  once  be  changed  to  equine  or 
into  an};  thing  which  you  think  better.  I  have  also  at  last  obtained, 
with  the  virus  of  grease  inoculated  with  six  more  children, 
fwo  vesicles  exactly  like  those  of  vaccine.  I  am  construing 
my  observations.  Everything  points  to  the  conclusion  that 
we  shall  procure  from  grease  a  virus  for  protection  against 
Small  Pox  without  the  iiitcrnicdiinn  of  the  cow. 

"  I  hope  that  this  new  proof  will  remove  the  doubts  which 
still  existed  about  the  origin  of  Cow  Pox.  I  will  publish  the 
results  of  these  experiments  in  a  work  on  vaccination,  to  which 
I  will  add  a  coloured  plate  of  grease." 

Jenner  replied  to  Sacco,  expressing  his  confidence 
in  his   original    theory. 

"  Accept  my  best  acknowledgments  for  your  very  kind  attention. 
I  am  extremely  gratified  by  your  goodness  in  sending  me  your 
pamphlet  on  Vaccine  Inoculation,  your  obliging  letter,  and  above 
all  the  virus  from  the  plains  of  Lombardy  I  am  confident  that 
wherever  the  horse  and  the  cow  are  domesticated  together,  and 
the  same  human  being  that  attends  the  one,  under  a  peculiar 
malady  of  the  foot,  milks  the  cow  also,  that  there  the  disease 
called  the  Cow  Pox  may  arise." 

In  Paris,  according  to  Baron,  equination  was  practised 

in    181  2. 

"  A  coachman  who  had  not  had  Small  Pox,  and  who  dressed 
a  horse  affected  with  the  grease,  had  a  crop  of  pustules  on 
his  hands,   which    resembled    the    vaccine.       Two    children   were 


390 


GREASE." 


inoculated  from  these  pustules,  and  the  genuine  vaccine  was 
excited  in  both  :  from  this  stock  many  successive  inoculations 
were  effected,  all  possessing  the  proper  character.  A  similar 
series  of  inoculations  took  place  from  another  infant  who  was 
infected  from  one  of  the  scabs  taken  from  the  pustules  on  the 
hand  of  the  coachman." 

In  spite  of  these  results  the  theory  was  still  dis- 
credited in  London,  and  Jenner  wrote  to  Moore, 
July  23rd,  181 3,  giving  information  of  a  fresh  stock 
of  equine  virus  which  he  had  been  using  for  months. 

"  In  one  of  your  letters  you  seemed  not  perfectly  satisfied 
that  the  fact  respecting  the  origin  of  the  vaccine  was  clearly 
made  out.  For  my  part,  I  should  think  that  Loy's  experi- 
ments, independently  of  my  own  observations,  were  sufficient 
to  establish  it,  to  say  nothing  of  Sacco's  and  others'  on  the 
Continent.  However,  I  have  now  fresh  evidence,  partly  foreign 
and  partly  domestic.  The  latter  comes  from  a  Mr.  Melon,  a 
surgeon  of  repute  at  Lichfield.  He  has  sent  me  some  of  his 
equine  virus,  which  I  have  been  using  from  arm  to  arm  for  these 
two  months  past,  without  observing  the  smallest  deviation  in  the 
progress  and  appearance  of  the  pustules  from  those  produced  by 
the  vaccine.  I  have  at  length  found  the  French  document  I 
formerly  alluded  to,  which,  with  Melon's,  shall  be  sent  to  you 
in    the  course  of  the  ensuing  week." 

Jenner  wrote,  again,  on  the  same  subject,  August 
ist,    1813. 

To    James    Moore,    Esq. 

"  Dear  Moore, — My  friend  and  neighbour,  Mr.  Hicks,  will 
deliver  to  you  the  promised  papers  respecting  equine  virus.  I 
have  been  constantly  equinating  for  some  months,  and  perceive 
not  the  smallest  difference  between  the  pustules  thus  produced 
and  the  vaccine.  Both  are  alike,  because  they  come  from  the 
same  source." 


VACCINE  lymph:' 


391 


And  again,   in  a  letter,  dated   October  27th,  181 3: — . 

"  I  am  sorr}'  you  have  not  succeeded  in  infecting  a  cow. 
I  have  told  you  before  that  the  matter  which  flows  from  the 
fissures  in  the  heel  will  do  nothing.  It  is  contained  in 
vesicles  on  the  edges  and  the  surrounding  skin.  Did  I  ever 
inform  you  of  the  curious  result  of  vaccinating  carters  ?  These 
people  from  their  youth  up  have  the  care  of  the  horses  used 
for  ploughing  our  corn  lands.  Great  numbers  of  them  in  the 
course  of  my  practice  here  have  come  to  me  from  the  hills  to 
be  vaccinated ;  but  the  average  number  which  resisted  has  been 
one  half.  On  inquiry,  many  of  them  have  recollected  having 
sores  on  their  hands  and  fingers  from  dressing  horses  affectevi 
with  sore  heels,  and  being  so  ill  as  to  be  disabled  from  fol- 
lowing their  work ;  and  on  several  of  their  hands,  I  have 
found  the  cicatrix  as  perfect  and  as  characteristically  marked 
as  if  it  had  arisen   from  my  own   vaccination." 

Jenner  now  appears  to  have  almost,  if  not  entirely, 
abandoned  vaccination  for  equination.  On  the  ist  of 
April,    181 7,   he  made  the  following  memorandum: — 

"  Rise  and  progress  of  the  equine  matter  from  the  farm  of 
Allen,  at  Wansell.  From  a  horse  to  Allen;  from  Allen  to  two 
or  three  of  his  milch  cows  ;  from  the  cows  to  James  Cole,  a 
young  man  who  milked  at  the  farm  ;  from  James  Cole  to  John 
Powell,  by  inoculation  from  a  vesicle  on  the  hand  of  Cole;  and 
to  Anne  Powell,  an  infant;  from  Powell  to  Samuel  Rudder; 
from  Rudder  to  Sophia  Orpin,  and  to  Henry  Martin  ;  from 
H.  Martin  to  Elizabeth  Martin.  All  this  went  on  with  perfect 
regularity  for  eight  months,  when  it  became  intermixed  with 
other  matter,  so  that  no  journal  was  kept  afterwards.  Prool 
was   obtained  of  the  patients  being  duly   protected." 

And    among   other   entries   to    a    similar  effect,   there 
was,  on  the  i  7th  of  May,  the  following  : — 


392  "GREASE." 

"  Took  matter  from  Jane  King  (equine  direct),  for  the 
National  Vaccine  Establishment.  The  pustules  beautifully 
correct." 

This  stock  of  equine  lymph  was  widely  diffused. 
Baron  and  many  medical  friends  received  supplies  of 
it,  and  it  was  also  introduced  into  Scotland. 

Baron  adopted  equination,  and  made  notes  of  cases 
of  o^rease. 

"  It  happened  to  me  to  see  one  case  of  this  kind  in  the 
autumn  of  the  year  1817.  A  young  man  in  this  neighbour- 
hood, who  had  dressed  a  horse  with  the  grease,  had  not  less 
than  fifty  pustules  on  his  hand  and  wrists.  They  exhibited  the 
true  character  of  the  Variolae  Vaccinae  when  taken  in  the 
casual  way.  The  pustules  were  too  far  advanced  to  permit  of 
any  experiments  being  made  with  virus  taken  from  them.  I 
cannot  refrain  from  remarking  in  this  place,  that  as  the  dis- 
ease, whether  caught  from  the  cow  or  the  horse,  is  much 
more  severe  than  when  communicated  by  inoculation,  so  it  like- 
wise differs  from  the  last  in  being  sometimes  what  may  be 
truly  called  an  eruptive  disease.  Besides  the  case  just  speci- 
fied, I  know  of  instances  where  the  disease,  when  it  has 
been  caught  from  cows  in  the  dairy,  has  produced  pustules 
more  extensively  diffused  over  the  body  than  in  the  case 
above  mentioned." 

In  the  following  year,   Baron  sent  some  fresh  equine 
virus    to    Jenner.      It   was   obtained   from   the  hands   of 
a    boy   who    had    been    infected  directly   from  a    horse. 
The    disease    assumed    a    pustular    form,    and    extended 
over  both  arms. 

Jenner  acknowledged  the  receipt  of  Baron's  virus 
in   the   following  letter  : — 


"  VACCINE  LYMPHr  393 


''April  25///,  18 1 8. 
"Yesterday  \\.  Shrapnell  brought  nic  the  equine  virus  and 
your  drawing,  which  conveys  so  good  an  idea  of  the  disease 
that  no  one  who  has  seen  it  can  doubt  that  the  vesicles  con- 
tain the  true  and  genuine  life-preserving  fluid.  I  have  inserted 
some  of  it  into  a  child's  arm  ;  but  1  shall  be  vexed  if  you 
and  some  of  your  young  men  at  the  Infirmary  have  not  done 
the   same   with   the   fluid   fresh   trom   the    hand." 

In  18 18,  Kahlert/  on  the  Continent,  confirmed  the 
experiments  made  by  Loy  and  Sacco. 

"In  the  month  of  May  1818,  one  of  my  friends  remarked  to  me 
that  two  horses  which  he  had  just  bought  were  not  in  their  usual 
state  of  health  ;  that  the}^  quickly  became  fatigued,  that  their  hind 
legs  were  stiff,  and  that  they  even  went  lame,  and  in  fact  he 
thought  they  were  suffering  from  javart  {jnaiike). 

"  These  two  horses  were  of  the  ordinary  breed  of  the  country 
(Bohemia),  black,  six  years  old,  well  nourished,  and  well  cared 
for,  but  according  to  the  groom  they  had  for  some  time  lost  their 
spirit  and  appetite.  ...  1  at  once  noticed  that  the  joint  of  the 
foot  was  swollen,  that  moisture  exuded  from  it,  and  that  the 
posterior  part  of  the  pastern  was  still  slightly  red  and  swollen, 
and  hotter  than  the  neighbouring  parts.  At  the  slightest  touch, 
the  animal  showed  signs  of  pain  ;  the  hair  was  stuck  together,  and 
a  clear  yellowish  fluid  with  a  peculiar  odour  escaped.  ...  I  was 
not  slow  in  recognising  the  fntc  equine  preservative.  I  collected 
the  fluid  on  a  lancet  to  inoculate  cows  and  children." 

The  experiments  on  cows  succeeded  ;  children  were  inoculated 
from  the  vesicles  which  resulted,  and  a  lymph  stock  was  started 
which  was  widely  used. 

In    an   appendix    to    the    second    volume   of  Jenner's 

Biography,  published  in  1837,  Baron  made  the  follov^ing 

remark  : — 

"  1   take  this  opportunity  of  expressing  my  regret  that   I   have 

'  L'Almanach  de  Carlsbad.  Du  javatit prcservatif  troicTC  en  Bo/ieme. 
'^^ii'     (Quoted  by  Auzias-Turenne.) 


394 


GREASEr 


employed  the  word  grease  in  alluding  to  the  disease  in  the 
horse.  Variolcc  Eqiiiiice  is  the  proper  designation.  It  has  no 
necessary  connexion  with  the  grease,  though  the  disorders  fre- 
quently co-exist.  This  circumstance  at  first  misled  Dr.  Jenner, 
and  it  has  caused  much  misapprehension  and  confusion." 

In  1840,  Ceely  remarked  that  there  were  farmers 
and  others  who  had  good  reason  for  beheving  in  the 
origin  of  Cow  Pox  from  the  equine  vesicle,  which  he 
regarded  as  eczema  inipetiginodes. 

Jenner's  theory  of  the  origin  of  Cow  Pox  has  been 
discouraged,  and  completely  replaced  by  the  theory  of 
Cow  Small  Pox,  advocated  so  strongly  by  Baron,  and 
supported  by  an  erroneous  interpretation  of  Ceely's 
and  Badcock's  variolation  experiments ;  and  thus  the 
"Cow  Pox"  and  the  "grease"  of  the  farmers  were 
no  longer  of  interest,  while  the  hypothetical  Cow  Small 
Pox,  which  could  never  be  discovered,  has  been  credited 
with  having  become  extinct,  since  the  days  of  Jenner. 
At  the  present  day  the  derivation  of  "  vaccine 
lymph "  from  a  disease  of  the  horse  is,  almost,  if 
not  entirely,  unknown  to  medical  practitioners,  and 
certainly  vaccinogenic  "  grease "  in  this  country  is  not 
differentiated  by  practical  veterinarians  of  the  present 
day,  from  the  various  diseases  which  it  simulates. 
Like  actinomycosis,  it  has  been  lost  sight  of  under  a 
variety  of  appellations.  I  would  draw  the  attention 
of  veterinarians  to  this,  by  giving  a  detailed  account 
of  the  researches  carried  out  by  veterinary  surgeons 
in  France. 


' '  VA  CCINE  L  YMPH. "  395 


First  Outbreak  at  Toulousk. 

In  i860,  the  horses  at  Rieumes,  near  Toulouse, 
were  attacked  by  an  epizootic  malady.  In  less  than 
three  weeks,  there  were  more  than  one  hundred  cases. 
According  to  the  veterinary  surgeon,  M.  Savrans,  the 
animals  suffered  from  slight  fever,  rapidly  followed  by 
local  symptoms,  the  most  marked  of  which  were  swell- 
ing of  the  hocks,  and  an  eruption  of  small  pustules 
on  the  surface  of  the  swollen  parts,  which  were  at 
the  same  time  hot'  and  painful.  After  three  to  five 
days  there  was  a  discharge  from  the  pastern,  which 
continued  for  eight  to  ten  days,  during  which  the 
inflammation  gradually  diminished.  The  pustules 
dried  up,  and  in  about  a  fortnight  the  crusts  with 
patches  of  hair  fell  off,  leaving  more  or  less  marked 
scars. 

The  eruption  appeared  at  the  same  time  on  different 
parts  of  the  body,  especially  on  the  nostrils,  lips, 
buttocks,  and  vulva.  Savrans  believed  that  the  mares 
taken  to  the  breeding  establishment  at  Rieumes  had 
been  infected  from  the  cords  which  had  been  used 
in  tying  up  other  affected  animals  and  had  become 
thereby  infected  with  the  virus  of  this  disease. 

One  of  the  mares  was  taken  by  the  owner,  M. 
Corail,  to  the  veterinary  school,  to  be  examined  by 
M.  Lafosse.  About  eight  days  after  this  visit,  signi- 
ficant   symptoms  appeared  :    loss   of  appetite,   lameness, 


396.  '' GREASEr 


Stiffness    of    both    pastern    joints,    and    a     hot,    painful 
swelling  of  the   left  pastern  joint. 

The  hair  was  staring,  and  there  were  vesicles  on 
the  skin,  from  which  a  liquid  exuded  having  an 
ammoniacal  odour,  but  less  foetid  than  the  secretion 
in  eaux  aux  janibcs. 

M.  Lafosse  regarded  it  as  a  case  of  acute  grease, 
and  this  led  him  to  inoculate  a  cow.  This  experiment, 
made  on  the  25th  of  April,  a  week  after  the  eruption 
had  first  appeared  on  the  mare,  was  completely 
successful.  On  the  teats  of  the  inoculated  cow,  at 
every  puncture,  there  were  large,  flat,  firm,  round, 
umbilicated  vesicles.  They  had  all  the  characters  of 
inoculated  Cow  Pox.  Another  cow  inoculated  with 
liquid  from  this  first  remove,  manifested  typical  vesicles, 
which,  transmitted  to  a  child  and  to  a  horse,  gave 
rise  in  both  cases  to  a  very  fine  "vaccinal"  eruption. 
A  child  inoculated  from  the  vesicle  of  this  horse  had 
also  "vaccine  vesicles."  On  making  a  comparative 
inoculation  with  current  vaccine  lymph  on  the  same 
subject,  the  vesicles  were  found  to  be  larger,  finer, 
and  slower  in  their  development.  When  M.  Lafosse 
detected  the  disseminated  eruption  on  various  parts 
of  the  body,  especially  around  the  lips  and  nostrils, 
he  recognised  that  the  disease  was  not  an  ordinary 
attack   of  grease. 

The  occurrences  at  Rieumes  and  Toulouse  were 
communicated   to    the   Academy   of   Medicine,    in    1862, 


VACCINE  LYMPHr  397 


by  M.  Bousquet  ;  and  M.  Renault  observed  that  the 
original  error  in  diagnosis,  made  after  a  cursory  ex- 
amination, by  M.  Lafosse.  added  greatly  to  the;  interest 
of  the  inoculation  experiment,  because  it  might  exjjlain 
the  difference  in  the  results  obtained  up  to  the  pre- 
sent time  by  medical  men  and  veterinary  surgeons 
who  since  Jenner  had  inoculated  the  grease.  Renault 
said  : — "  It  may  be  possible  that  the  few  experi- 
menters who  assert  that  they  have  seen  Cow  Pox 
result,  under  their  hands  and  eyes,  from  accidental 
or  experimental  inoculation  of  the  matter  of  the  grease, 
were  in  reality  dealing  with  the  vesicular  malady  of 
Toulouse,  while  the  much  larger  number  of  them  who 
obtained  no  effect  from  their  inoculations  must  have 
employed  the  discharge  from  the  true  grease,  which 
was  formerly  so  common." 

Renault  added  : — "  The  occurrence  at  Toulouse  is 
of  great  importance  in  drawing  attention  to  this 
subject,  which  will  lead  to  further  discussion.  It 
will  teach  veterinary  surgeons  that  there  is  an 
affection,  principally  manifested  on  the  horse's 
heels,  which  appears  up  to  this  time  to  be  readily 
mistaken  for  the  grease,  from  which,  however,  it  can 
be  easily  distinguished  by  attentive  examination.  It 
will  teach  them  how  important  it  is  to  study  at  the 
same  time  the  characters  of  this  disease,  and  the 
effect    pf  inoculation." 


398  ^'GREASEr 


Outbreak  at  Alfort. 


In  1863,  the  subject  of  Horse  Pox  again  received 
great  attention  in  France.  A  student  named  Amyot 
dressed  a  horse  on  which  an  operation  had  been  per- 
formed. The  leg  which  had  been  operated  on  (right 
hind  leg)  became  the  seat  of  a  very  confluent  eruption 
of  Horse  Pox,  which  was  followed  by  such  an  abun- 
dant flow  of  serosity  that  at  flrst  the  nature  of  the 
affection  was  mistaken,  and  it  was  thought  to  be  a 
complication  of  eaux  aiix  jambes.  Amyot  had  a 
wound  on  the  dorsal  aspect  of  the  first  interphalangeal 
joint  of  the  little  finger  of  his  right  hand  ;  in  spite 
of  this,  he  continued  to  dress  the  horse  entrusted  to 
his  care.  The  sore  on  his  finger  was  the  seat 
of  an  accidental  inoculation  with  the  virus  which 
flowed  in  such  great  abundance  from  the  horse's 
leg.  The  wound  was  made  on  the  3rd  of  August, 
and  the  next  day  it  was  swollen  and  rather  pain- 
ful. On  the  5th,  Amyot  suffered  from  malaise  and 
great  weakness,  on  the  6th,  7th,  and  8th,  vesicles 
appeared  successively  on  the  fingers  of  his  left  hand, 
on  his  forehead,  on  a  level  with  the  root  of  his  nose, 
and  between  the  two  eyebrows.  On  the  9th,  these 
vesicles  were  fully  developed  ;  those  of  the  fingers 
consisted  of  very  large  epidermic  bullae  on  a  bluish- 
red  base.  On  opening  them,  a  perfectly  limpid  fluid 
escaped     in     such      abundance     that     small     test-tubes 


"  VACCINE  LYMPH. 


399 


mio^ht  have  been  filled  with  it.  The  vesicle  on  the 
forehead  was  surrounded  by  a  bluish-red  areola,  within 
which  the  epidermis  of  a  leaden-grey  hue  was  raised 
and  had  a  slight  central  depression.  The  liquid 
which  flowed  from  it  when  it  was  opened,  and  which 
continued  to  ooze,  was  also  very  abundant  and  of 
a  deep  citrine   colour. 

The  vesicles  which  had  developed  on  the  dorsal 
side  of  Amyot's  fingers  were  extremely  painful.  The 
incessant  shooting  pains,  of  which  they  were  the  seat, 
prevented  him  from  getting  any  rest  for  three  days. 
On  the  loth,  inflammation  of  the  lymphatics  followed  ; 
both  arms  were  swollen  and  very  painful,  with  red 
lines  indicating  the  course  of  the  lymphatic  vessels. 
The  glands  of  the  axilliE   were  also  enlarged. 

The  lymphatic  glands  behind  the  jaws  were  also 
swollen  and  painful.  Amyot's  chief  sufferings  were 
occasioned  by  the  intense  local  pain  caused  by  the 
vesicles  on  the  fingers,  and  by  the  inflammation  of 
the  lymphatic  vessels  and  glands,  and  they  continued 
in  this  state  up  to  the  i8th  of  August.  It  was  only 
at  the  end  of  the  month  that  the  vesicles  were 
completely    cicatrized. 

Bouley  felt  very  great  anxiety  in  the  presence  of 
the  grave  symptoms  which  accompanied  the  eruption, 
so  closely  did  these  symptoms  resemble  in  their  mode 
of  manifestation  and  their  intensity  the  effects  of  an 
inoculation     much     more    alarmino^    than    those    of    the 


400  "  grease:' 

virus  of  grease.  The  eruption  on  the  forehead  was, 
especially,  a  cause  of  great  uneasiness,  because  glanders 
manifests  itself  in  a  similar  way.  But  when,  on  the 
morning  of  the  9th,  Amyot  showed  Bouley  the 
pustules  on  his  fingers  and  on  his  forehead  fully 
developed,  the  latter  was  completely  reassured,  for 
he  recognised  without  any  hesitation,  that  they  had 
the  characters  of  "  vaccine  vesicles."  This  diagnosis 
was  supported  by  Drs.  Marchant,  Auzias-Turenne, 
Bayer,  Depaul,  and  Blot,  who  successively  saw 
Amyot  on  the  same  day,  and  had  only  one  opinion 
as  to  the  nature  of  his  malady.  Amyot  evidently  had 
inoculated  himself  with  the  grease  which  Jenner  and 
Loy  had  seen  and  described.  They  were  of  opinion, 
that  Amyot's  illness  had  been  much  more  severe  and 
had  lasted  for  a  longer  time,  than  in  others  who  had 
been  victims,  as  he  had  been,  of  an  accidental 
inoculation  with   Jennerian   grease,    or   Loy's  disease. 

To  complete  the  history  of  Amyot,  and  to  demon- 
strate that  the  malady  which  he  had  contracted,  while 
attending  to  the  horse,  was  really  Horse  Pox,  Bouley, 
on  the  1 2th  of  August,  inoculated  the  liquid  taken 
from  the  vesicles  on  his  fingers,  in  the  scrotal  region 
of  a  steer,  and  produced  "magnificent  Cow  Pox," 
which,  when  inoculated  on  a  child,  was  followed  by  a 
very  fine  vaccinal  eruption. 

This  case  of  Amyot,  so  well  circumstantiated  and 
studied  in  all  its  details,    was   fresh   evidence   in   favour 


' '  VA  CCINE  L  YMPH. "  40 1 


of  Loy's  opinion  that  the  equine  virus  is  n^ifted  with 
greater  energy  than  that  of  the  cow,  and  produces  a 
much  more   marked  effect  on  the  human  subject. 

The  outbreak  at  Alfort  enabled  exhaustive  experi- 
ments to  be  made,  by  which  it  was  definitely  esta- 
blished that  Horse  Pox  is  never  infectious,  l)ut,  like 
Cow   Pox,   is  transmitted  solely  by  contact. 

Not  having  been  able  to  get  any  practical  informa- 
tion on  the  subject  of  Horse  Pox'  in  this  country,  I 
made  it  one  of  my  principal  objects  during  a  visit 
to  France  to  inquire  into  and,  if  possible,  practically 
study  this  malady.  It  was,  therefore,  with  great  in- 
terest that  I  heard  that  Professor  Peuch,  of  Toulouse, 
had  not  only  investigated  outbreaks  of  this  disease, 
but  also  was  in  the  possession  of  drawings  illustrating 
its  different  manifestations.  Professor  Peuch  described 
to  me  his  experience,  giving  me  the  details  ot  his 
observations,  and  allowed  me  to  have  copies  made  of 
his  valuable  drawings.  I  cannot,  do  full  justice  to 
]\I.  Peuch's  admirable  researches  unless  I  give  the 
full    details    in    his    own    words. 


'  The  term  equine,  as  a  substitute  for  vaccine,  was  first  employed  by 
Sacco,  in  a  letter  to  Jenner,  in  1803  (p.  389);  and  both  equine  and 
Horse  Pox  were,  independently,  proposed  by  Mr.  Brown  of  Musselburgh. 
Vide  An  inquiry  into  the  afiti-variolous  fower  of  'Vaccination^  p.  63. 
180Q. 


VOL.    I. 


26 


402  "  GREASE." 

Second  Outbreak  at  Toulouse. 

M.  C.  Baillet,  Director  of  the  National  Veterinary 
School  of  Toulouse,  having  been  informed  that  a  con- 
tagious malady  had  developed  in  the  mares  which  had 
been  served  by  the  stallions  at  the  breeding  establish- 
ment at  Rieumes  belonging  to  M.  Mazeres,  delegated 
M.  Peuch  to  inspect  these  animals  in  order  to  ascertain 
the  nature  of  the  illness  with  which  they  were  affected, 
its  mode  of  propagation,  and  the  means  of  arresting  it. 

With  this  object  in  view,  M.  Peuch  visited,  on  the 
loth  and  iith  of  May,  1880,  at  Berat,  Rieumes,  and 
Labastide-Clermont,  several  mares  which  had  been 
served  by  the  stallions  of  M.  Mazeres,  and  also  the 
stallions  themselves. 

M.  Peuch  reported  the  result  of  his  investigations 
in  the  Reviie  Vet^7'inaire  de  Toiiloitse,  the  following 
July. 

"  At  Berat,  I  examined,  in  the  presence  of  my  colleague, 
M.  Averadere,  three  mares  alread}^  attacked,  and  these  I  will 
speak  of  as  Nos.  i,  2,  and  3. 

"  No.  I.  A  mare  (Isabel)  eight  3^ears  old,  had  been  served  on 
25th,  27th,  and  30th  of  April.  This  animal  showed  on  the  lips 
of  the  vulva  a  sort  of  cicatricial  mark  of  a  whitish  colour,  of  an 
elongated  form,  with  edges  scalloped  and  slightly  in  relief, 
covered  here  and  there  by  a  few  brownish  crusts,  and  showing 
elsewhere,  and  principally  in  the  neighbourhood  of  the  folds 
of  the  vulval  orifice,  small  reddish  superficial  ulcers.  Towards 
the  upper  commissure  of  the  vulva  there  were  several  round  or 
oval  scars,  the  size  of  a  large  lentil ;  some  obvious]}^  depressed 
in   the     centre,    which    was    covered    by    a    small     crust  ;     others 


"  T'A  CCINE  L  YMPH. ' '  403 


were  circular  like  little  leprous  marks.  I  did  not  observe  any 
pustule,  or  a  trace  of  one  on  other  parts  of  the  body.  There 
was  not  any  lesion  on  the  nose,  in  the  nostrils,  on  the  internal 
surface  of  the  lips,  or  in  the  mouth.  This  mare,  who  was  very 
spirited,  retained  her  full  vigour,  and  it  did  not  appear  as  if  the 
eruption  had  weakened  her  in  any  way. 

"No.  2.  A  black  mare,  eight  years  old,  had  been  served  on  the 
26th  and  28th  of  April.  Several  ulcerated,  reddish,  circular  sores 
surrounded  b}^  a  cicatricial  zone,  existed  on  the  lips  of  the 
vulva,  notably  towards  their  free  edge.  The  majority  had 
attained  the  size  of  a  twenty-centime  piece.  There  was  not 
any  eruption  in  the  nostrils,  the  mouth,  or  the  internal  surface 
of  the  lips  ;  no  modification  of  the  general  condition  ;  no  difficulty 
in  locomotion. 

"  No.  3.  A  bay  mare,  eight  years  old,  had  been  served  the 
23rd,  25th,  27th,  and  30th  of  April.  At  the  circumference  of 
the  vulva  there  were  very  numerous  white,  lenticular,  slightly 
elevated,  isolated,  or  confluent  marks,  extending  over  the  peri- 
naeum.  These  marks,  w^hich  were  only  dried  pustules,  showed 
at  their  centre,  which  was  appreciably  depressed,  a  blackish  dry 
and  adherent  crust,  under  which  the  skin  had  a  bright  red  colour 
when  the  central  crust  was  raised.  I  also  established  the  existence 
of  dried  pustules,  showing  the  same  characters  as  the  preceding, 
on  the  under  surface  of  the  tail,  where  they  were  disseminated  in 
considerable  numbers.  I  scraped  off  these  crusts  with  the  nail  and 
preserved  them.  On  the  lower  part  of  the  left  flank  a  discoid 
vesicle  was  discovered  with  a  diameter  of  about  a  centimetre. 
On  raising  the  crust  which  covered  it,  a  sero-sanguinolent 
liquid  oozed  from  the  exposed  surface.  There  was  nothing  to 
remark  on  other  parts  of  the  body.  The  general  state  was 
most  satisfactory  ;  there  was  no  lameness. 

'•  Such  were  the  symptoms  which  I  observed  at  Berat  on  the 
loth  of  May.  To  what  disease  were  the}'  attributable?  Were 
they  to  be  considered  as  indications  of  the  malady  sometimes 
known  as  syphilis,  or  the  venereal  disease  of  the  horse  {inaladie 
venc'riennc  dii  cheval)  ?  This  is  a  very  important  question  in  the 
interests  of  the  breeder  and  the  owner  of  stallions,  which  cannot 
be  too  carefulh'  investigated,  for  when  an  eruptive  disease  appears 


404  "GREASEr 

after  coition,  in  a  locality  abounding  with  breeding  mares, 
the  alarmed  breeder  thinks  it  must  be  a  syphilitic  malady,  and 
it  therefore  remains  for  the  veterinary  surgeon  to  explain  the 
true  nature  of  the  illness.  But  the  symptoms  which  I  have 
just  described  belonged  obviously  to  an  eruptive  affection  in 
the  stage  of  desiccation,  and  even  cicatrisation  in  No.  i  ;  so 
that  the  diagnosis,  the  consequences  of  which  are  so  important, 
must  offer  serious  difficulties,  especially  to  the  practitioner  who 
has  not  had  the  opportunity  of  observing  similar  cases.  I  do 
not  hesitate  to  remark  that  it  appears  very  difficult,  not  to  say 
impossible,  to  recognise  with  certainty  the  nature  of  the  eruption 
in  question,  when  it  is  seen  in  a  subject  for  the  first  time,  in 
the   stage  of  desquamation. 

"  But  such  was  not  the  case  in  this  outbreak. 

"  Having  several  times  had  the  opportunity  of  examining 
mares  with  a  vesicular  eruption  around  the  vulva,  after  coition 
(an  eruption  which  I  had  been  able  to  follow  from  its  first 
appearance  to  complete  cicatrisation,  and  which  was  shown  by 
inoculation  of  the  cow  to  be  Horse  Pox),  I  found  myself  in 
a  favourable  position  to  appreciate,  at  their  true  value,  the 
symptoms  which  I  had  discovered  in  the  above-mentioned  mares. 
Recalling  to  mind  what  I  had  observed  on  several  occasions,  I 
asserted  that  it  was  a  case  of  the  disease  which  M.  Bouley,  in 
1863,  called  Horse  Pox,  and  which  Auzias-Turenne  proposed  to 
distinguish  by  the  name  pustular  grease  {grease  piisiuleiix),  a 
malady  essentially  different  from  la  maladie  dn  co'it,  or  dotirine, 
but,  like  it,   propagated  during  coition. 

"After  this  inspection  at  Berat  I  proceeded  to  Rieumes,  to  the 
same  establishment  where,  twenty  years  previously,  a  sort  of 
enzooty  had  appeared,  which  has  been  described  in  the  historical 
records  of  Vaccination,  and  which  gave  M.  Lafosse  the  oppor- 
tunity of  rediscovering  the  vaccinogenic  disease  of  the  horse, 
which  was  considered  extinct,  since  the  days  of  Jenner,  or  at  any 
rate  the  greatest  confusion  existed  as  regards  diagnosis.  I  there 
inspected  eleven  stallions,  six  horses,  and  five  asses.  All,  with 
the  exception  of  the  breeding  stallion  Totiche-a-tonf,  which  at 
other  times  was  readily  excited,  served  mares  in  my  presence,  so  that 
I  was  able  to  examine  the  penis  of  each  before  the  act  of  coition. 


Facing  page  404 
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Following  Plate  XVI 11. 
n.ATK   XIX. 


NATURAL     HORSE     POX     (  P  E  I  C  H  ). 


"  VACCINE  LYAIPFir  405 


"  On  one  ass  (Aramis)  I  observed  on  the  right  side  of  the  penis 
several  vesicles,  scattered  about  troni  the  base  of  the  free  part  to 
the  head  of  this  organ.  These  vesicles,  which  were  flattened 
and  circular,  varied  in  diameter  from  the  size  of  a  lentil  t^  that 
of  a  twenty-centime  piece  ;  they  had  at  their  periphery,  which 
was  slightly  in  relief,  a  greyish  colour ;  at  their  centre,  where  the 
epidermis  had  been  destroyed,  they  presented  a  bright  rose  colour 
and  a  finely  granular  appearance.  All  these  vesicles  were  distinct 
from  each  other,  and  there  was  no  infiltration  or  swelling  of  the 
penis.  A  little  above  the  circular  swelling  which  constitutes 
the  base  of  the  free  part  of  the  penis,  a  little  dried  vesicle  was 
found  with  a  central  brownish  crust.  On  another  ass,  called 
Mexico,  I  saw,  on  one  aspect  of  the  penis,  a  little  whitish  spot, 
circular  but  not  in  relief,  on  the  skin,  which  appeared  to  me  to 
be  the  scar  of  a  grease  vesicle.  Whatever  this  might  have  been, 
this  animal  had  on  the  external  wing  of  the  left  nostril,  a  small 
pustule,  which,  nevertheless,  showed  well  the  characters  of  the 
vesicles  of  Cow  Pox,  or  of  '  grease.'  I  did  not  meet  with  any  trace 
of  eruption  on  other  parts  of  the  body,  but  it  is  not  impossible 
that  some  dried  vesicles  may  have  escaped  my  notice;  for  it  can 
be  readily  imagined  how  easy  it  is  to  overlook  them  in  asses,  with 
so  long  a  coat.  On  the  other  three  breeding  asses  I  could  not 
detect  any  vesicle  or  trace  of  vesicle  either  on  the  penis,  the  nose, 
around  or  within  the  lips,  in  the  hollow  of  the  heel,  or,  indeed 
in  any  part  of  the  body,  which  I  examined  as  well  as  I  was 
able  to  considering  the  extreme  liveliness  of  these  animals,  which 
fidgeted  without  intermission.  I  can  say  the  same  of  the  six 
stallions,  which  I  examined  with  the  greatest  care  without  being 
able  to  find  any  trace  of  the  eruptive  disease,  observed  on  the 
three  mares  and  the  two  asses. 

"  But  I  can  assert  that  all  these  stallions  had  coition  with  great 
ardour  and  without  any  sign  of  weakness,  that  their  gait,  their 
proud  and  confident  bearing,  their  repeated  and  sonorous  neighings, 
all,  in  fact,  including  their  impatience,  which  rendered  examination 
difficult,  testified  to  their  extreme  energy  and  to  their  some- 
what exuberant  health.  What  a  contrast  to  the  maladie 
(in  coil!  Moreover,  amongst  the  mares  which  had  already  been 
served    by    the     Rieumes      stallions,     and     were     presented     to 


4o6  "  grease:' 

them  again,  I  remarked  two  which  I  will  designate  as  Nos.  4 
and  5,  and  over  which  1  think  it  useful  to  pause  for  a  few 
moments. 

"  No.  4.  Very  old  bay  mare.  This  animal  showed  traces 
of  an  eruption  of  Horse  Pox  on  the  circumference  of  the  vulva  : 
here  and  there  little  dried  and  flattened  vesicles  were  to  be 
seen  passing  on  to  cicatrisation.  I  should  mention  that  as  the 
proprietor  of  this  mare  had  not  been  alarmed  by  the  eruption,  no 
treatment  had  been  employed,  and  the  cicatrisation  took  place 
naturally  and  in   the  ordinary  way. 

"No.  5.  A  white  mare,  eighteen  years  old,  was  served  on 
the  22nd  and  26th  of  April.  On  the  lips  of  the  vulva  there  were 
some  vesicles  of  grease  passing  on  to  desiccation.  In  addition 
on  the  inside  of  the  lower  lip,  near  to  the  attached  border,  there 
was  found,  on  the  right  side,  a  very  fine  vesicle  of  a  pale  yellow 
colour,  of  an  ellipsoidal  form,  and  of  the  size  of  a  pea,  not 
flattened  or  umbilicated,  but  well  rounded,  projecting,  smooth, 
and  of  a  pearly  appearance.  By  the  side  of  this  vesicle  or  bulla 
a  second  was  noticed,  smaller,  and  not  exceeding  a  hemp  seed 
in  volume,  and  with  the  summit  slightly  eroded.  I  may  say,  in 
passing,  that  an  inexperienced  observer  might  have  considered 
these  vesicles  to  indicate  aphthous  stomatitis;  but  if  we  recall  the 
remarkable  observations  contributed  by  H.  Bouley  to  the  article 
on  Horse  Pox  in  the  NotivcaiL  Dictionnaire  de  medecine  et  de 
chinirgie  ve'te'rinaires,  concerning  a  case  of  an  eruptive  malady 
of  the  horse  which  was  in  the  first  place  taken  for  aphthous 
stomatitis,  but  the  inoculation  of  which  produced  Cow  Pox,  in 
the  cow  submitted  to  the  experiment ;  or  if  the  opportunities  of 
the  dinique  had  even  cnce  brought  to  your  notice  the  supposed 
aphthous  stomatitis  with  an  eruption  on  the  circumference  of 
the  nostrils,  in  the  hollow  of  the  heel,  or  on  other  parts  of  the 
body,  it  would  no  longer  be  possible  to  be  misled  as  to  its 
nature,   and  to  mistake  Horse  Pox  or  equine  variola. 

"  In  addition  to  these  animals,  I  inspected  in  the  commune  of 
Labastide  Clermont,  a  mare  which  had  been  especially  brought  to 
my  notice  as  suffering  in  a  very  marked  degree  from  the  effects 
of  the  malady.      I  will  speak  of  her  as  No.  6. 

"  No.   6.     A  bay  mare,    nine  years  old,    served  the    19th   and 


Facing  fagt  406. 
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7tiiaKtSnebAff*Si»>JM. 


Following  Plate  XX. 
J'l.A'JK     VXl 


' '  VA  CCINE  L  YMPH. ' '  .,07 


2ist  of  April.  I  was  informed  that  this  mare  was  at  iirst  attended 
to  by  her  master,  who  was  a  farrier;  and  afterwards  M.  Averadere, 
veterinary  surgeon  at  Berat,  was  called  in.  On  the  occasion  of 
my  visit,  the  nth  of  May,  1880,  I  observed  traces  of  an  eruption 
around  the  vulva  ;  traces  which  were  similar,  but  more  extensive 
than  those  on  subject  No.  i  already  described,  so  I  need  net 
again  describe  them.  However,  1  will  remark  that  lymphangitis 
existed  in  the  right  posterior  limb,  which  was  engorged,  hot,  and 
painful  in  its  whole  extent,  and  the  animal  walked  at  first  with 
difficulty.  I  did  not  see  the  eruption  in  the  hollow  of  the  heel, 
but  there  was  a  greyish  vaccinal  vesicle,  partly  desiccated,  near 
the  lower  commissure  of  the  left  nostril.  I  will  now  add  that 
the  proprietor  of  this  mare  had  a  vaccinal  vesicle  on  the  thumb 
of  the  right  hand,  excoriated  and  blackened,  but  recognisable, 
contracted  in  attending  to  his  mare.  This  casual  inoculation 
confirmed  entirely  the  diagnosis  which  I  had  made  the  evening 
before  at  Berat,  although  no  doubt  existed  in  my  own  mind, 
inasmuch  as  the  symptoms  observed  in  the  asses  Araniis  an.-i 
Mexico,  and  in  mares  Nos.  4  and  5,  already  demonstrated  to  my 
eyes  the  existence  of  Horse  Pox,  Moreover,  the  day  after  my 
return  to  Toulouse,  that  is  to  say  on  the  12th  of  May,  I  directed 
M.  Cadeac,  a  fourth-year  student,  to  inoculate  the  crusts  which 
1  had  collected  at  Berat  two  days  before,  from  mare  No.  3.  This 
inoculation  was  made  in  the  presence  of  the  pupils,  in  a  cow 
twelve  years  old  belonging  to  M.  Givelet,  and  she  was  placed  in 
the  hospital  of  the  school.  M.  Cadeac  made  several  punctures 
with  a  lancet  on  the  circumference  of  the  vulva  of  this  animal, 
into  which  he  introduced  a  droplet  of  a  mixture  obtained  by 
crushing  the  crusts  in  a  little  water.  On  the  20th  of  May,  a 
flattened  vaccinal  vesicle  had  formed  at  one  of  the  inoculated 
points,  having  a  diameter  of  about  a  centimetre  ;  it  was  depressed 
in  the  centre  which  was  occupied  by  a  thin  crust ;  the  periphery 
was  markedly  circular,  forming  a  sort  of  crown  slightly  in  reliel. 
The  colour  of  this  vesicle  was  obscured  by  that  of  the  lips  of  the 
vulva  ;  they  were  quite  black  in  our  experimental  cow ;  moreover, 
the  epidermis,  which  was  thin,  and  raised  by  the  accumulated 
lymph  at  the  periphery  of  the  vesicle,  presented  a  greyish  glis- 
tening appearance.     Having  taken  off  the  crust  and  the  epidermic 


4os  "  grease:' 


pellicle  which  covered  the  vesicle,  we  observed  after  a  few 
seconds  some  very  fine  transparent  amber-coloured  droplets 
of  vaccinal  lymph,  welling  up  on  the  surface  of  the  skin. 

"  On  the  20th  of  May,  1880,  a  heifer  six  and  a  half  months 
old,  in  excellent  condition,  belonging  to  M.  Givelet,  was  inocu- 
lated with  this  vaccine.  A  great  number  of  punctures  were 
made  around  the  vulva,  and  between  the  thighs,  and  on  the 
right  side  of  the  udder,  and  on  the  teats.  Several  students 
revaccinated  themselves,  and  on  two  of  them  vesicles  formed. 
The  inoculation  on  the  heifer  took  perfectly,  so  that  on  the 
26th  of  May  each  puncture  was  transformed  into  a  flattened 
discoid  vesicle,  umbilicated  in  the  centre,  of  a  yellow-grey 
colour  with  an  inflammatory  areola,  presenting,  in  one  word, 
all  the  characters  of  the  vesicles  of  Cow  Pox.  With  the 
liquid  contained  in  these  vesicles  I  successfully  vaccinated 
several  children,  and  revaccinated  some  students,  some  of 
whom  showed  vaccinal  vesicles.  On  the  26th  of  May,  Dr. 
Salamon  vaccinated  children  who  had  very  fine  vesicles. 
Lastly,  two  water-colour  drawings  were  made  by  one  of  the 
most  eminent  artists  of  Toulouse,  M.  Loubat,  one  representing 
the  vaccinal  eruption  of  the  heifer,  and  the  other  that  of  one 
of  the  vaccinated  children,  forming,  in  a  way,  unimpeachable 
evidence  of  these  inoculations,  which  had  been  made  in  the 
presence   ol'  most  of  my  colleagues  and  pupils. 

"  No  doubt  can,  therefore,  be  raised  of  the  exactness  of  the 
diagnosis  which  1  made  as  early  as  the  loth  of  May,  at  Berat, 
after  seeing  the  mares  which  had  been  served  by  the  stallions 
belonging  to  M.  Mazeres  ;  and,  if  I  insist  on  this  question  of  the 
diagnosis  of  Horse  Pox,  when  this  malady  is  seen  on  mares  which 
have  been  recently  served,  it  is  because  it  appears  to  me  that  it 
has  not  been  studied  in  such  a  manner  as  to  furnish  practitioners 
with  really  useful  means  of  recognition. 

"  Some  writers  on  pathology  say  that  the  imiladic  dn  co'it 
may  be  accompanied  by  an  eruption  which  some  describe  as 
papular,  vesicular ;  others,  as  formed  of  white  spots  or  diph- 
theritic ulcerations.  Some  assert  that  this  eruption  appears 
sometimes  in  the  form  of  herpes  or  of  eczema,  sometimes  of 
ecthyma,  with  or  without  the   nialadie  du  co'it.      M.   Lafosse   has 


• '  VA  CCINE  L  YMPH. "  409 


even  thought  that  it  'would  not  be  perhaps  impossible  that  one 
of  the  breeding  animals,  male  or  female,  through  sexual  connection 
with  difterent  individuals,  might  generate  these  varieties.  Fresh 
observations  ought  to  be  collected  to  establish  the  possibility  of 
these  results  being  varied  by  the  diverse  copulations  of  the  same 
animal.  While  waiting  for  these  observations,  it  appears  to  us 
prudent  to  admit  it  in  practice,  from  the  present  time,  not  to 
bhndl}'  endanger  the  life  of  the  reproductive  animals,  and  also 
in  order  to  free  ourselves  from  the  heavy  responsibility  which 
would  encumber  us  under  certain  circumstances  if  the  mutability 
of  the  morbid  properties  of  the  genital  secretions  were  to  be 
demonstrated.' 

"It  is  not  difficult  to  conceive  what  perplexities  such  a  doc- 
trine would  give  rise  to  in  the  mind  of  the  practitioner,  and 
what  consequences  it  might  have,  as  it  leads  one  to  consider  all  the 
eruptive  affections  of  the  genital  organs  as  originating  from  the 
same  source  as  the  maladie  du  co'tt,  if  not  as  manifestations  of  this 
disease.  But  observation  pure  and  simple,  and  freed  from  all 
fantastic  ideas,  pronounces  against  this  singular  theory  of  the 
mittability  of  morbid  properties ;  in  other  words,  the  maladie  du  co'i't 
is  one  thing  and  Horse  Pox  is  another.  And  I  proved  this  by 
inoculating  the  cow  with  an  eruptive  illness  which  I  had  observed  ; 
the  inoculation  gave  rise,  in  the  cow,  to  a  perfectly  genuine  Cow 
Pox,  which  developed  in  the  child  to  whom  it  was  transmitted 
an  eruption  of  irreproachable  purity,  a  fact  which  allows  us  to 
regenerate  the  vaccine,  and  to  procure  for  ourselves  at  any  time, 
and  in  any  place,  a  vaccine  as  pure  and  as  active  as  that  which 
Jenner  himself  employed.  I  do  not  assert  that  the  maladie  du 
co'it  and  Horse  Pox  cannot  exist  simultaneously  on  the  same  sub- 
ject. 1  own  to  having  no  information  on  this  subject,  and 
there  is  not,  to  my  knowledge,  any  observation  which  proves 
it.  Nevertheless,  1  consider  that  such  a  fact  would  not  be  in 
opposition  to  the  principles  of  the  pathology  of  the  contagious 
maladies,  and  I  am  not  unwilling  to  admit  it  as  having  been 
demonstrated.  We  should  then  know  how  the  practitioner 
should  act  should  such  a  thing  occur,  and  how  he  can  correctly 
foresee  all  the  consequences  of  the  disease  which  he  has  under 
observation. 


410  "  GREASE." 

"  1  have  no  intention  here  of  discussing  the  complete  patho- 
logical history  of  the  uialadie  du  co'it.  I  will  confine  myself 
to  remarking  that  cutaneous  plaques  have  been  mentioned  as  a 
very  important  symptom  in  the  course  of  this  affection ;  they 
form  projections  of  three  to  four  millimetres,  of  a  diameter  vary- 
ing from  a  centimetre  to  five  centimetres ;  they  appear  on  the 
neck,  shoulder,  flank,  forearm,  and  some  other  parts.  These 
plaques,  are  the  seat  of  an  oozing,  which  lasts  for  eight,  ten, 
and  twelve  days,  then  they  gradually  become  effaced  without 
leaving  any  trace  behind.  It  would  be  puerile  to  point  out  to 
the  reader  the  great  differences  between  this  eruption  of  cutaneous 
plaques  and  that  which  characterises  Horse  Pox.  They  can  be 
readily  appreciated  when  we  recall  the  characters  of  the  vaccine 
vesicles  and  compare  them  to  those  of  the  cutaneous  plaques, 
which  in  a  way  constitute  the  specific  eruption  of  the  maladie 
du  co'it.  Nor  will  it  be  difficult  to  distinguish  Horse  Pox  from 
the  vesicular,  papular,  and  other  eruptions  which  have  been 
the  subjects  of  such  varied  descriptions,  if  inoculation  in  the 
cow  formed  for  the  practitioner  the  true  criterion  of  the  illness 
which  he  has  under  observation.  But  it  is  clear  that  having 
admitted  the  possibility  of  the  development  of  the  maladie  du 
co'it  and  of  Horse  Pox  in  the  same  subject,  I  ought  to  ascertain 
if  there  are  not  other  points  which  enable  the  practitioner  to 
form  a  well-grounded  opinion  about  the  illness  under  observation. 
The  time  has  come  to  apply  the  data  acquired  by  science  respect- 
ing the  etiology  of  douriue  or  tnaladie  du  co'it.  I  cannot  do 
better  than  reproduce  here  a  passage  from  a  clinical  lecture  of 
Professor  St.  Cyr  of  the  School  of  Lyons.  This  learned  and 
respected  teacher,  after  having  reviewed  all  the  causes  which 
have  been  invoked  to  afford  an  explanation  of  the  development 
of  douriue,  formulates  among  other  conclusions  the  following 
propositions  : 

"  *  That  the  true  cause  of  the  maladie  du  co'it,  when  we  know 
how  to  look  for  it,  will  be  found  in  the  importation  of  a  foreign 
stallion.'' 

"'That  dourinc  has  only  one  known  cause,  contagion;  that 
all  the  others  to  which  it  has  been  thought  possible  to  at- 
tribute   it,    are    more    than    problematical,    and    that  in   practice, 


VACCINE  LYMPIir  411 


as  well  as  in  theory,  there  is  no  ground  for  believing  in 
them.' 

"  And  M.  St.  Cyr  adds  '  doiiriiic  is  not  an  autochthonous  malady 
born  from  local  influences,  but  is,  on  the  contrary,  an  exotic 
illness  which  has  been  imported,  and  the  origin  of  which  it  will 
be  always  possible  to  trace  if  the  practitioner  exercises  in  his 
etiological  investigation  the  attention  and  the  perspicacity  which 
it  requires.' 

"  This  announcement  throws  light,  it  seems  to  me,  on  the 
differential  diagnosis  of  doiirinc.  Shall  I  add  that  even  if  this 
malady  were  mistaken  at  its  initial  period,  it  would  not  be  long 
in  declaring  itself  by  wasting,  weakness,  and  an  exaggerated 
sensibility  of  the  lumbar  region  ;  a  sharp  flexion  of  the  posterior 
pastern  joints,  the  appearance  of  cutaneous  plaques,  then  of 
at  first,  partial  paralysis,  etc.,  all  being  symptoms  which  enable 
us  to  distinguish  doiirine  from  Horse  Pox,  the  course  of 
which  is  at  the  same  time  so  simple  and  so  mild.  These 
are  phenomena  known  to  all  practitioners  who  have  had  the 
opportunity  of  seeing  the  real  maladie  du  co'it. 

"To  sum  up,  if  an  eruptive  malady  appear  after  coition, 
inoculation  of  the  cow  furnishes  a  valuable  diagnostic  sign  to  the 
observer,  which  it  appears  to  me  useful  to  insist  upon,  owing 
to  the  good  results  which  it  gives. 

"  I  now  approach  a  question  which  appears  to  me  to  be  not 
less  interesting  than  that  of  the  diagnosis.  I  wish  to  speak 
of  the  contagion  of  Horse  Pox  from  the  facts  which  I  was  able 
to  observe  at  Rieumes. 

"The  information  furnished  to  me  by  M.  Mazeres,  the 
proprietor  of  this  breeding  establishment,  concerns  five  out  of 
the  six  mares  which   I  examined.      It  establishes  : — 

"That  mare  No.  i  was  served  'three  times  by  different  asses, 
25th,  27th,  30th  of  April  last.'  Mare  No.  2,  '  served  twice  by 
the  same  ass,  Mexico,  26th,  28th  of  April.'  Mare  No.  3  'served 
four  times  by  the  same  ass,  Mistigry,  the  23rd,  25th,  27th,  and 
30th  of  April.'  No  information  about  mare  No.  4.  Mare  No.  5, 
'  served  twice  by  the  same  horse.  Sultan,  22nd  and  26th  of  April.' 
Mare  No.  6,  '  served  twice  by  the  same  ass,  Porthoiis,  22nd  and 
26th  of  April.' 


412  "  GREASEr 

"  If  the  reader  will  now  recall  what  I  have  already  mentioned 
about  the  state  of  health  of  the  stallions  of  the  serving  stall  at 
Rieumes,  he  will  see  that,  in  spite  of  the  attention  with  which 
I  examined  these  animals,  I  found  on  only  two  of  them — the 
asses  Aramis  and  Mexico — the  characteristic  eruption  of  Horse 
Pox.  However,  in  the  first  place,  Mare  No.  3,  which  had  been 
served  by  the  ass  Misiigry,  on  which  I  did  not  observe  any 
eruption  of  Horse  Pox,  exhibited  a  splendid  vaccinal  eruption 
which  had  even  developed  on  the  under  surface  of  the  tail,  where 
I  collected  crusts,  inoculation  from  which  proved,  as  we  have 
seen,  an  excellent  source  of  vaccine  ;  in  the  second  place.  Mare 
No.  6,  served  by  the  ass  Portlwns,  had  a  very  confluent 
perivulvar  eruption  with  consecutive  lymphangitis,  although 
I  was  not  able  to  discover  the  smallest  vesicle  on  the  penis  of 
Porihoits  or  elsewhere ;  finally  the  horse  Sultan  showed  no 
vaccine  vesicles  and  nevertheless  the  mare  No.  5,  which  he  had 
served,  had  been  infected  with  an  eruption  which  had  left  obvious 
traces  on  the  circumference  of  the  vulva  and  on  the  buccal 
mucous  membrane,  where  the  vesicles  were  found  which  I  have 
described,  and  which  I  consider  to  be  Horse  Pox.  As  to  mares 
Nos.  I  and  2,  covered  by  the  ?-ame  asses  Aramis  and  Mexico, 
their  contamination  was  explained  ;  but  what  are  we  to  think 
of  the  appearance  of  Horse  Pox  on  the  mares  served  by 
stallions  whose  penis  showed  no  vesicle  ?  A  pnori  it  may 
perhaps  be  admitted  that  the  development  of  Horse  Pox  preceded 
coition,  and  that  this  eruption,  being  at  first  discrete,  passed 
unnoticed  by  the  groom  as  well  as  by  the  breeder,  or  indeed, 
that  there  was  a  simple  coincidence  between  the  occurrence  of 
this  eruption  and  the  coitus,  without  any  connecting  link. 
These  suppositions  doubtless  are  not  improbable,  nevertheless 
neither  one  nor  the  otlier  appears  to  me  to  be  well  founded 
considering  the  special  seat  of  the  eruption  on  the  circumference 
of  the  sexual  parts  and  its  development  after  coition,  on  five 
out  of  six  mares  which  I  examined.  We  must  then  endeavour 
to  find  out  how  the  contagion  was  carried  when  the  penis  of 
the  stallion  was  free   from  all  lesions. 

"  Must  we   in   this    connection,  admit    with    M.    Lafosse,    that 
the   mfectious  agent   does  not  exist  before   the   coitus,   that  it  is 


"  VA  CCINE  L  1  'MPH. "  413 


formed  during  the  accomplishment  of  the  act  of  copulation, 
doubtless  at  the  expense  of  the  male  or  female  secretions,  perhaps 
of  both,  and  under  the  influence  of  the  nervous  influx  or  force 
which  is  accumulated  in  the  genital  organs  by  the  friction  of 
copulation  ? 

"  But  I  do  not  see  on  what  principle  or  on  what  scientific 
ground  this  theory  rests,  and  therefore  it  is  quite  useless  to 
pause  longer  over  it. 

"  Let  us  see  if  it  be  not  possible  to  give  a  more  simple  and 
rational  interpretation  from  the  facts  which  I  have  established. 
I  think,  with  M.  St.  Cyr,  that  it  may  be  possible  that  '  without 
being  ill  themselves,  the  stallions  were  the  mediatory  agents  of 
contagion,  by  carrying  to  health}'  mares  virus  which  they  had 
taken  from  diseased  ones ;  in  this  way  they  would  play  the 
part  of  corps  contumaccs  as  they  say  in  Sanitary  Police^  and 
nothing  more.' 

"  Do  we  not  know  that  Horse  Pox  can  be  communicated  by 
the   sponge  ? 

"  M.  Arloing  has  explained  the  presence  of  this  eruption  on 
the  circumference  of  the  vulva  of  four  mares,  from  the  habit 
which  the  groom  had  of  washing  every  morning  the  sexual 
organs  of  these  animals  with  the  same  sponge.  Moreover,  the 
sponge  is  not  the  only  object  which  can  act  as  the  agent  in 
transporting  the  virulent  matter.  The  hobbles,  the  litter,  the 
blunt  hook  which  is  employed  in  the  operation  for  javart,  and 
even  the  finger  of  the  operator,  have  communicated  Horse  Pox, 
as  Trasbot  and  Nocard  have  observed  in  several  cases  ;  and  it 
would  be  difficult  to  understand  wh}'  the  penis  of  the  stallion 
should  not  be  a  means  of  transporting  virulent  matter,  in  the 
same  way  as  an  inert  body  or,  accidentally,  the  finger  of  the 
surgeon.  This  being  explained,  I  will  finish  this  paper  with 
son.e  practical  considerations  on  the  prophylaxis  of  Horse  Pox. 
In  the  first  place,  I  will  remark  that  Horse  Pox  transmitted  by 
coition  is  not  of  importance,  except  from  the  fear  which  it 
inspires  in  breeders,  and  which  immediately  induces  them  to 
regard  this  eruptive  affection  as  syphilitic.  And  this  alarm, 
consequently,  brings  discredit  upon  the  breeding  establishment 
whence    the    illness    has     spread.       It    is    the    business    of    the 


414  "  GREASE r 

veterinary  surgeon  to  reassure  the  breeders,  by  acquainting  them 
with  the  exact  consequences  of  this  affection,  of  the  diagnosis 
which  they  are  able  to  establish.  And,  not  to  put  it  too 
strongly,  it  will  also  gain  him  the  esteem  and  confidence  of 
his  fellow-citizens,  and,  I  am  not  afraid  to  assert,  that  in  thus 
acting  he  will  have  done  more  to  reconcile  the  interests  in 
question,  than  by  giving  himself  up  at  random  to  theoretical  dis- 
cussions, which  are  necessarily  useless  to  the  practitioner  who 
is  always  endeav^ouring  to  cope  with  the  difficulties  of  his  art. 

"  The  nature  of  the  malady  being  perfectly  recognised,  is  it 
not  in  all  cases  necessary  to  have  recourse  to  sanitary  pre- 
cautions ?  I  have  every  reason  to  think,  from  my  own  observa- 
tions and  those  of  various  practitioners,  especially,  Lautour,  who 
saw  on  the  penis  of  a  stallion  'a  score  of  little  pustulous 
tumours,  the  size  and  shape  of  variolous  pustules,'  that  Horse 
Pox  is  of  no  more  importance  when  it  appears  after  coition 
than  when  it  appears  under  any  other  circumstance,  for  example, 
during  an  attack  of  strangles.  And  then  do  we  not  know 
that  vaccination  of  the  horse  has  been  considered  as  a  measure 
preventive  of  strangles  ?  Doctor  Sacco,  quoted  by  Gohier 
in  1813,  reports  that  he  had  vaccinated  '  eighty-three  breeding 
mares  and  that  none  of  them  had  ever  been  attacked  with 
strangles.'  Last  year  Professor  Tasbert,  of  the  school  of  Alfort, 
asserted  the  identity  of  strangles  and  Horse  Pox,  which 
he  proposed  to  call  variola  of  the  horse,  and  recommended 
the  same  means  for  preventing  the  complications  of  strangles. 
Doubtless  at  the  time  when  the  mares  are  put  to  the  stallions 
they  have  generally  passed  the  age  at  which  strangles  appears, 
but  it  will  be  readily  admitted  that  a  fresh  attack  of  Horse 
Pox,  like  revaccination,  would  best  serve  to  guarantee  the  pro- 
tection of  the  organism  against  a  fresh  attack  of  strangles,  if 
such  a  guarantee  exists.  In  this  case,  a  mare  which  may  have 
an  eruption  of  Horse  Pox  around  the  vulva  and  on  the  teats, 
which  is  not  unusual  will  herself  transmit,  the  preservative  virus 
to — I  was  going  to  say  to  vaccinate — the  colt  or  the  mule 
which  she  suckles,  and  this  would  be  all  for  the  best,  as  the 
young  animal  would  be,  for  the  future,  protected  from  the  serious 
effects  of  strangles. 


VACCINE  LYMPHr  415 


However  this  may  be,  Horse  Pox  developed  around  the  vulva, 
at  the  end  of  the  nose,  in  the  mouth,  and  in  the  hollow  of  the 
heel,  is  always  Horse  Pox  ;  therefore,  when  the  eruption  is 
confluent  and  pruriginous,  simple  cleanliness  is  sufficient  or 
lotions  of  fresh  water  whitened  by  a  few  drops  of  goulard 
water  to  accelerate  cicatrisation,  which  is  generally  completed 
by  the  third  week.  If  lymphangitis  supervene,  simple  emollient 
lotions,  gentle  w-alking  exercise,  nitrate  drinks,  and  green  food 
will  easily  subdue  it.  Even  if  the  comphcations  are  very  slight 
it  ma}'  be  useful  to  anticipate  them  to  a  certain  extent. 

"  With  this  object  it  will  be  advisable  to  let  the  stallion  rest 
for  several  days  when  there  is  a  confluent  eruption  seen  on 
the  penis,  and,  in  the  same  way,  mares  affected  with  the  vaccino- 
genic  eruption  must  be  temporally  put  out  of  use.  Finally,  the 
groom  is  recommended  to  pass  a  paint  brush  imbued  with  oUve 
oil  on  the  lips  of  the  vulva  of  the  mare,  before  she  is  served,  as 
this  diminishes  the  chances  of  absorption. 

''After  what  I  have  written  in  the  preceding  pages  it  will  be 
understood  that  these  precautions  are  only  of  secondary  import- 
ance, and  that  the  practitioner  ought,  above  everything,  to  be 
able  to  determine  the  true  nature  of  the  contagious  malady  which 
he  has  under  observation.  I  shall  consider  myself  happy  if  the 
present  work  should  prove  useful  in  this  respect." 

Horse  Pox  in  Algeria. 

About  eighteen  months  afterwards  M.  Peuch  met 
with  a  case  of  Horse  Pox  in  Algeria.  An  account 
was  published  in  the  Rei>ue    Vdterinaire,   July   1882. 

"  The  24th  of  last  October,  being  at  Boufarik,  I,  and  one  of 
my  old  pupils,  M.  Renaud,  veterinary  surgeon  of  that  commune, 
observed  a  splendid  example  of  the  vaccinogenic  illness  in  a 
horse,  a  thoroughbred  Arab,  four  and  a  half  years  old,  belonging 
to  one  of  the  principal  colonists  of  Mitidja,  M.  Debonno.  The 
following  are  the  sj-mptoms  which  I  observed  on  the  subject  in 
question  : — Around  the  nostrils  there  were  numerous  flattened 
discoid,  umbilicated  vesicles   the   size  of  a  lentil ;  some  were  in 


4i6  "  GREASEr 

process  of  desiccation,  others  in  full  secretion  from  which,  on 
the  slightest  pressure,  a  limpid  fluid  exuded  of  an  amber  colour. 
Towards  the  inferior  commissure  of  the  left  nostril  we  noticed 
a  superficial  ulceration,  the  size  of  a  silver  five-franc  piece,  with 
scalloped  edges,  covered  in  part  by  crystalline  crusts,  which  were 
yellowish  and  transparent ;  elsewhere  the  skin  exhibited  a  bright 
red  colour,  and  a  delicately  areolar  aspect.  A  yellowish  serous 
discharge  escaped  from  the  left  nostril.  The  pituitary  mem- 
brane was  strongly  injected,  notably  on  the  side  corresponding  to 
the  discharge,  where  on  the  nasal  septum  vesico-pustules  could 
be  seen  of  the  size  of  a  small  lentil,  of  a  rounded  form,  and  of 
a  whitish  and  yellowish  colour.  In  the  mouth,  and  particularly 
inside  the  lips  and  on  the  lateral  s  urfaces  of  the  tongue,  there  were 
a  multitude  of  small  bullae  or  vesicles  of  pearly  appearance  and  of 
the  size  of  a  pea  ;  some  were  isolated  and  prominent,  the  greater 
number  confluent  and  as  if  eroded  at  their  centre  ;  a  viscous 
saliva  escaped  in  abundance,  while  the  mouth  was  being  ex- 
amined. The  sublingual  glands,  especially  those  on  the  left 
side,  were  engorged,  hot,  and  painful  on  pressure.  The  coat 
in  pit:hes  on  the  lateral  aspect  of  the  neck,  on  the  shoulders, 
the  flanks,  and  in  the  hollow  of  the  heel,  was  staring,  giving  the 
appearance  of  small  paint  brushes.  On  passing  the  hand  over  these 
parts,  small  lenticular  nodules  were  felt,  which  were  nothing  else 
than  the  vesicles  of  Horse  Pox — some  of  them  dry,  others 
secreting.  The  animal  appeared  dejected,  depressed  ;  there  was, 
moreover,  slight  fever,  and  the  appetite  had  fallen  off  Con- 
sidering these  symptoms,  and  above  all  the  appearance  of  the 
perinasal  eruption,  M.  Renaud  and  I  did  not  hesitate  to  assert, 
in  the  presence  of  Dr.  Chafnuis,  of  Boufarik,  that  it  was  a  case 
of  the  eruptive  illness  of  the  horse  which  M.  Bouley  has 
proposed  to  call  Horse  Pox,^  from  two  English  words,  horse 
and  pox  (variola).  It  was  decided  to  collect  the  liquid  which 
oozed  from  the  vesicles,  and  to  preserve  it  between  pieces 
of  glass.  Being  obliged  to  leave,  the  same  day.  for  Oran 
where  I  was  expected,  I  charged  my  old  pupil,  M.  Renaud, 
to  collect  the  virus,  and  I  am  happy  to  be  able  to  say  that  he 

'  Vide  p.  401. 


'itlJf'l.CCu. 


■-'Of/M-  i.^u//- 


^^^« 


VACCINE  LYMPH!'  417 


acquitted    himself  in    the    most    satisfactory  manner.       We    had 
also  decided  that  inoculations  should  he  made  on  cows. 

In  a  letter  dated  the  4th  of  November  last,  M.  Renaud 
informed  me  that,  having  inoculated  four  heifers,  fifteen  to  ten 
months  old,  with  the  Horse  Pox  in  question,  he  had  obtained 
Cow  Pox.  In  the  same  letter  M.  Renaud  informed  me  that  three 
horses,  which  had  eaten  from  the  same  manger  as  the  one  which 
we  had  inspected  on  the  24th  of  October  last,  were  attacked, 
the  4th  of  November  following,  with  very  well  characterised  Horse 
Pox.  It  appears  to  me  useful  to  mention  this  fact,  as  it  indicates 
a  mode  of  transmitting  Horse  Pox  which  is  generally  ignored. 
Having  said  this  I  return  to  our  first  observation. 

"On  the  2 1st  of  December  last  I  begged  M.  Renaud  to  send 
me  some  of  the  Horse  Pox,  and  the  vaccine  which  he  had 
cultivated.  In  a  most  obliging  way,  for  which  I  cannot  thank 
him  too  much,  my  young  colleague  sent  me  on  the  loth  of 
January  following,  two  slips  of  glass  charged  with  Horse  Pox 
virus  obtained  from  the  subject  which  we  had  visited  together, 
and  two  slips  with  vaccine  collected  from  the  heifers  which  he 
had  inoculated.  I  received  this  packet  on  Sunday,  the  15th 
of  January  last,  and  the  same  day,  with  the  concurrence  of  my 
colleague,  Professor  Bidaud,  I  inoculated,  at  the  experimental 
farm  attached  to  the  Veterinary  School  of  Toulouse,  belonging 
to  M.  Givelet  at  Montredon — ist,  an  Ayrshire  cow  aged  about 
nine  years,  in  an  advanced  stage  of  gestation,  with  the  dried 
Horse  Pox  previously  moistened  in  a  drop  of  tepid  water ;  I 
made  twenty  punctures  around  the  vulva  and  the  perinaeum. 
2nd,  another  cow,  seven  years  old,  also  in  a  state  of  advanced 
gestation,  with  the  Cow  Pox  which  had  been  derived  from 
the  Horse  Pox.  I  proceeded  in  the  same  way  as  on  the 
previous  subject.  The  19th  of  January,  the  fifth  day  after 
the  inoculation,  I  observed  that  on  these  two  animals,  the 
punctures  exhibited  no  inflammatory  process,  except  one  or 
tw^o  amongst  them,  which  were  slightly  papular,  all  the  others 
were  no  longer  visible,  so  that  I  thought  that  my  culture  would 
remain  sterile.  I  own  that  I  was  agreeably  surprised  on  seeing 
on  Tuesday  last,  24th  of  January,  when  I  was  on  a  weekly 
excursion  with    the  pupils  to  the    farm,  that  the  greater  part  of 

VOL.   I.  27 


4i8  "GREASE:' 

the  punctures  made  ten  days  before,  which  were  invisible  on  the 
19th  of  January,  were  now  transformed  into  fine  vaccinal  vesicles 
surrounded  by  an  areola  of  a  rose-colour.  And  the  25th  of 
January  last,  these  two  cows  were  taken  to  the  Veterinary  School 
of  Toulouse  where,  in  conjunction  with  M.  Cadeac,  teacher  of  the 
Clinique,  I  vaccinated  two  fine  Dutch  heifers  vigorous  and  in  good 
health,  one  aged  fourteen  months,  the  other  seven  months.  Five 
da3's  later  there  were  as  many  vesicles  as  there  had  been  punc- 
tures, and  Drs.  Armieux,  Jougla,  Caubet,  and  Parant,  invited  by 
the  Director  of  the  Veterinary  School  to  visit  the  vaccinated 
heifers,  proved  the  perfect  genuineness  of  the  vaccinal  eruptions, 
which  had  been  produced  on  the  perinaeum  and  on  the  teats. 

"  This  eruption  has  been  the  starting  point  of  cultures  of 
vaccine  on  heifers  and  calves  up  to  the  end  of  last  May,  and 
the  vg.ccine  thus  kept  up,  has  been  used  for  vaccination  of  about 
fifteen  hundred  persons." 

In  this  country,  it  is  more  than  probable  that  some 
of  Jenner's  stocks  of  equine  lymph  are  still  in  use ; 
but  equination  is  not  wittingly  practised,  for  it  is 
commonly  supposed  that  all  the  lymph  employed  for 
the  purposes  of  vaccination  has  been  derived  from 
Cow  Pox.  In  France,  on  the  other  hand,  it  is 
extensively  employed.  M.  Layet  informed  me  that  at 
the  Animal  Vaccine  Station  at  Bordeaux,  the  lymph 
which  gave  most  satisfaction  was  derived  from  the 
horse,  and  that  he  had  been  able  on  two  occasions 
to  renew  his  stock  from  equine  sources. 


CHAPTER  XV. 

INTRODUCTION    OF    VACCINATION  IN  FOREIGN 
COUNTRIES. 

In  a  former  chapter,  an  account  has  been  given  of  Small 
Pox  inoculation  in  foreign  countries.  The  methods 
employed  and  the  results  of  this  practice  are,  historically 
and  pathologically,  of  the  greatest  interest ;  but  the  fact 
of  its  having  been  adopted  all  over  the  civilised  world, 
stands  in  an  important  relation  to  the  introduction  of 
vaccination.  Variolation  was  the  forerunner  of  vacci- 
nation, and  it  was  the  widespread  adoption  of  the 
former,  which  paved  the  way  for  the  latter.  Jenner 
did  not  evolve  an  entirely  new  system  of  medical 
treatment,  but  he  proposed  a  different  form  of  an 
already  existing,  but  dangerous,  practice.  I  will  now 
briefly  refer  to  the  reception  of  his  proposal  on  the 
Continent. 

The  Inquiry  was  made  known  to  the  scientific  world 
on  the  Continent,  through  the  medium  of  the  Biblio- 
thcque  Britannique.  Early  in  1800,  vaccine  lymph 
was  despatched  to  Hanover  and  Vienna,  and  Dr.  de 
Carro,    who    particularly    distinguished    himself  by    his 


420  INTRODUCTION  OF   VACCINATION. 

zeal  in  employing  the  new  inoculation,  greatly  assisted  in 
diffusing  a  knowledge  of  vaccination  throughout  Europe. 
From  Vienna,  lymph  was  conveyed  by  Dr.  Peschier 
to  Geneva ;  but  there  the  new  method  received  a 
temporary  check,  for  all  the  persons  who  were  vac- 
cinated, afterwards  contracted  Small  Pox,  some  by 
infection,  and  others  by  inoculation.  These  untoward 
results  were  explained  as  the  result  of  "spurious  vac- 
cination," and  the  practice  was  not  therefore  abandoned. 
Dr.  Odier  was  another  powerful  advocate  of  the  new 
inoculation.  He  drew  up  a  paper  on  the  subject, 
which  was  handed  by  clergymen  to  parents  when  they 
brought  their  children  to  be  baptized. 

In  Hanover,  vaccination  was  introduced  by  Ballhorn 
and  Stromeyer,  and  Jenner's  work  was  translated  by 
the  former  into  German.  In  Prussia,  the  clergy  were 
particularly  active  in  assisting  the  profession  to  spread 
the  "  benign  preventive,"  and  in  Russia,  it  was  widely 
employed  after  receiving  the  patronage  of  the  Dowager 
Empress.  Vaccine  lymph  was  obtained  by  the 
Empress  from  a  physician  at  Breslau,  and  an  infant 
was  vaccinated  by  the  surgeon  to  the  Emperor.  The 
child  was  named  Vaccinoff,  and  a  provision  settled  on 
her  for  life.  In  Sweden,  though  variolous  inoculation 
had  become  "  one  of  the  most  lucrative  branches  of 
professional  practice,"  the  subject  was  re-investigated 
by  the  College  of  Health  ;  this  learned  body  pro- 
nounced   in    favour  of  the    "  Jennerian   discovery,"   and 


FOREIGN  COUNTRIES.  421 


vaccination  was  established  throughout  the  kino-dom. 
In  France,  the  Director  of  the  School  of  Medicine 
at  Paris,  received  some  vaccine  lymph,  and  thirty- 
children  were  inoculated  ;  but  the  stock  was  soon  lost. 
Woodville  took  a  fresh  stock  to  Boulogne,  and  pro- 
ceeded from  thence  to  Paris,  and  a  bulletin  announced 
the  event  "of  France  having  now  got  Dr.  Woodville, 
a  learned  man,  animated  with  generous  zeal,  and 
meriting  gratitude  and  praise.  Already  he  had  vacci- 
nated six  thousand  children  with  invariable  success,  for 
the  prevention  of  the  Small  Pox  is  a  kind  of  prodigy."  ^ 

In  Italy,  vaccination  was  introduced  by  Sacco,  who 
investigated  the  origin  of  vaccine  lymph,  and  succeeded 
in  raising  stocks  trom  a  disease  of  cows  in  Lombardy, 
from  the  ulcerated  heels  of  horses,  and  from  Sheep 
Pox.  Sacco  was  instrumental  in  persuading  the 
Milanese  Government  to  adopt  strong  measures,  and 
we  are  also  told  that  "proclamations  were  read  from 
every  pulpit  ;  vaccination  was  practised  in  every  church, 
and  the  clergy  gave  such  effectual  aid,  that  the  professor 
and  his  associates,  in  three  years,  vaccinated  seventy 
thousand  persons,  and  extinguished  the  Small  Pox  in 
Lombardy."  ^ 

In  1800,  Joseph  Marshall  and  John  Walker  "procured 
medical  diplomas  from  the  indulgent  university  of 
Leyden,    and    being    low    in    fame    and    pocket,    made 


'  Moore.     The  History  a7id  Practice  of  Vacciiiati'm.     p.  254.     18  j  7. 
-  Moore,     loc.  cit.   p.  263. 


42  2  INTRODUCTION  OF   VACCINATION. 

application  to  Dr.  Jenner,  and  obtained  his  sanction 
for  a  very  useful  project."^  Jenner  obtained  a  passage 
for  them  in  a  frigate,  and  they  proceeded  to  Gibraltar, 
Minorca,  Malta,  Palermo,  and  Naples,  teaching  and 
practising  vaccination.  Having  finished  his  vaccine 
tour,  Marshall  wrote  a  description  to  Jenner,  which 
contained  the  following  account  of  the  introduction 
of  vaccination  into  Palermo: — 

"  It  was  not  unusual  to  see,  in  the  mornings  of  the  pubhc 
inoculation  at  the  hospital,  a  procession  of  men,  women,  and 
children,  conducted  through  the  streets  by  a  priest  carrying 
a  cross,  come  to  be  inoculated.  By  these  popular  means  it 
met  not  with  opposition,  and  the  common  people  expressed 
themselves  certain  that  it  was  a  blessing  sent  from  Heaven, 
though  discovered  by  one  heretic  and  practised  by  another," 

Vaccination  rapidly  found  its  way  to  Cadiz,  Seville, 
Barcelona,  and  all  the  principal  cities  of  Spain  ;  and  Dr. 
Francisco  Xavier  Balmis,  physician  to  his  Majesty, 
still  further  extended  the  practice,  for  he  obtained 
permission  to  diffuse  the  new  inoculation  in  the 
Spanish  American  and  Asiatic  dominions.  To  defray 
expenses,  "  he  obtained  the  rare  and  profitable  per- 
mission of  freighting  a  ship  with  a  variety  of  goods, 
and  of  trading  at  every  port  he  touched."  The 
Canary  Islands,  Porto  Rico,  Caraccas,  Lima,  Chili, 
Charcas,  Havannah,  Yucatan,  Guatemala,  Acapulco, 
the  Philippine  Islands,  Macao,  Canton,  and  St.   Helena 

•  Moore.     The  History  and  Practice  of  Vaccination,     p.  264. 


FOREIGN  COUNTRIES.  423 


were  also  visited  by  either  Balmis  or  his  assistants, 
who  asserted  the  efficacy  of  Cow  Pox,  "  not  merely 
in  preventing  the  Natural  Small  Pox,  but  in  curing 
simultaneously  other  affections  of  the  human  frame."  ' 

Lymph  from  the  National  Vaccine  Establishment 
was  taken  to  Persia  by  the  British  ambassador. 
From  Vienna,  Dr.  de  Carro  sent  lymph  to  Constan- 
tinople, and  thence  to  Bombay.  In  India,  the  new 
method  was  opposed  by  the  natives,  but  their  objec- 
tions were  overcome  by  an   ingenious  device. 

"  In  order  to  overcome  their  prejudices,  the  late  Mr.  EUis,  of 
Madras,  who  was  well  versed  in  Sanscrit  literature,  actually 
composed  a  short  poem  in  that  language  on  the  subject  of 
vaccination.  This  poem  was  inscribed  on  old  paper,  and  said 
to  have  been  found,  that  the  impression  of  its  antiquity  might 
assist  the  eftect  intended  to  be  produced  on  the  minds  of  the 
Brahmins,  while  tracing  the  preventive  to  their  sacred  cow." 

The  universal  appreciation  of  the  danger  of  inocula- 
ting Small  Pox,  the  promise  of  everlasting  security 
by  means  of  a  harmless  substitute,  and  the  exercise 
of  the,  so-called  pious,  frauds  which  have  been 
referred  to,  explain  at  once  the  rapid  acceptance  of 
vaccination  by  ignorant  peasants;  but  the  acceptance 
of  Cow  Pox  inoculation  by  the  scientific  world  requires 
another  explanation  which  however  is  not  difficult  to 
find. 


'  Letter  from  Doctor  Edward  Jenner  to  William  Dillwyn,  Philadelphia 
p.  16.     1818. 


424  INTRODUCTION  OF   VACCINATION. 

The  principle  embodied  in  the  practice  of  Small 
Pox  inoculation  was,  the  widespread  belief  that  in 
certain  diseases,  a  mild  attack  would,  as  a  rule,  ward 
off,  or  modify,  a  second  attack.  Now,  in  the  case  of 
Cow  Pox  there  was  this  initial  difficulty,  that  it  was 
a  disease  totally  distinct  from  Small  Pox.  As  was  soon 
pointed  out.  Cow  Pox  and  Small  Pox  are  radically 
dissimilar.^  That  Jenner  foresaw  this  difficulty,  and 
endeavoured  to  meet  it  by  the  invention  of  the  term 
variolcB  vaccines,  or  Small  Pox  of  the  cow,  is  not 
at  all  unlikely  ;  but  whether  there  was  motive  or  not, 
the  designation  of  Cow  Pox  as  variolcB  vaccincr  had, 
without  doubt,  a  very  great  effect  in  rendering  the 
new  inoculation  acceptable  on  the  Continent.  The 
physicians  abroad  were  thus  led  to  believe  that 
vaccination  embodied  the  same  principle  of  obtaining 
protection  from  Small  Pox  by  inducing  a  mild  attack 
of  that  disease ;  it  was  not,  in  other  words,  obtaining 
immunity  from  Small  Pox  by  a  totally  distinct  disease, 
but  by  another  kind  of  Small  Pox — viz.,  variolcE 
vaccines ,   or  Small   Pox  of  the  cow. 

Thus,  for  example,  Aubert,^  in  France,  in  the  intro- 
duction to  his  report  on  the  new  inoculation,   wrote  :— 

•'  On  a  donne  le  noni  de  Vaccine,  a  une  espece  de  boutoii, 
particLiliere  au  pis  des  vaches.  Par  le  contact  du  pus  qu'il 
renferme,    ce    bouton    si    reproduit    siir   Thomme,    et    lui    ote    la 

'  Moseltiy.     A  'Treafise  on  the  Lues  Bovilla  or  Cow  Fox.     1804. 
-  Aubert.     RaJ)J)urt  sitr  la  vaccine.     An.  IX. 


FOREIGN  COUNTRIES.  425 

susceptibilite  de  prendre  la  petite  verole.  Le  Docteur  Jenner,  fut 
le  premier  Medecin  qui,  jugeant  cette  tradition  des  gens  de  la  cam- 
pagne  digne  d'examen,  etudia  la  nature  et  les  effets  de  cette  eruption 
pustuleuse,  appelee  en  Angleterre  Petite  Verole  des  Vaches." 

In  America,  Cow  Pox  inoculation  was  introduced 
by  Dr.  Benjamin  Waterhouse,  who  wrote  an  article 
in  the  Columbian  Sentinel,  March  12th,  1799, 
headed  :  "  something  curious  in  the  medical  line." 
The  disease  was  described  as  "  Coiv  Pox,  or,  if  you 
like  the  term  better,  the  Cow  Small  Pox,  or  to  express 
it   in    technical   language,   the   variolce  vaccines^ 

The  virtues  of  the  Jennerian  discovery  were  thus 
described  : — 

"  But  what  makes  this  newly  discovered  disease  so  very  curious 
and  so  extremely   important  is,  that  every  person   thus   affected  is 

EVER    AFTER    SECURED     FROM     THE    ORDINARY    SMALL    POX,    Ict   llllll    be 

ever  so  much  exposed  to  the  effluvium  of  it,  or  let  ever  so  much  ripe 
matter  be  inserted  iuto  the  skin  by  inoculation." 

Waterhouse  preferred  the  use  of  the  terni  I^tne 
Pox  to  express  this    "wonderful  antidote." 

"  From  Kine,  the  plural  of  cow  ;  thus  in  the  Scriptures  '  and  they 
took  two  Milch  Kine,  and  shut  up  their  calves  at  home  ; '  a  word 
equally  expressive,  and  in  the  opinion  of  some  more  delicate." 

Dr.  Waterhouse  inoculated  his  son,  Daniel,  five 
years    old,    with    some    of  Jenner's    lymph.' 


'  Waterhouse.     A  Pros  feet  of  Extermiimtiiig  the  Small  Pox,  being  a 
History  of  the  Vai-iolcB  Vaccince  or  Kine  Pox,  p.  19.     1800. 


426  INTRODUCTION  OF   VACCINATION. 

"  The  inoculated  part  in  this  boy  was  surrounded  by  an  efflores- 
cence which  extended  from  his  shoulder  to  his  elbow,  which  made 
it  necessary  to  apply  some  remedies  to  lessen  it ;  but  the  '  symp- 
toms,' as  they  are  called,  scarcely  drew  him  from  his  play  more 
than  an  hour  or  two,  and  he  went  through  the  disease  in  so  slight 
a  manner  as  hardly  ever  to  express  any  marks  of  peevishness.  A 
piece  of  true  skin  was  fairly  taken  out  of  the  arm  by  the  virus,  the 
part  appearing  as  if  eaten  out  by  a  caustic,  a  never-failing  sign  of 
thorough  infection  of  the  system  in  the  inoculated  Small  PoxP 

Waterhouse  carried  on  some  further  inoculations, 
and  became  convinced  that  the  Kine  Pox  w^as  a 
disease    not    to    be    trifled    with. 

To  demonstrate  the  alleged  protective  pov^er  of 
Cow  Pox  against  Small  Pox,  Waterhouse  resolved 
to  have  the  variolous  test  applied,  and  enlisted  for 
this  purpose  the  services  of  Dr.  Aspinwall,  physician 
to  the  Small  Pox  Hospital  near  Boston.  Dr. 
Aspinwall  acceded  to  the  proposal,  and  inoculated 
Daniel    in    the    presence    of  his    father 

*'  by  two  punctures,  and  with  matter  taken  that  moment  from  a 
patient  who  had  it  pretty  full  upon  him.  He  at  the  same  time 
inserted  an  infected  thread,  and  then  put  him  into  the  hospital 
where  was  one  patient  with  it  in  the  natural  way.  On  the  fourth 
day  the  doctor  pronounced  the  arm  to  be  infected.  It  became 
every  hour  sorer,  but  in  a  day  or  two  it  dried  off,  and  grew  well 
without  producing  the  slightest  trace  of  a  disease,  so  that  the  boy 
was  dismissed  from  the  hospital,  and  returned  home  the  twelfth 
day  after  the  experiment.  One  fact  in  such  cases  is  worth  a 
thousand  arguments." 

The  pamphlet  concluded  with  the  following 
statement  : — 


FOREIGN  COUNTRIES.  42; 


"  Dr.  Waterhouse  informs  those  who  have  applied  to  him  out 
of  Cambridge,  to  inoculate  their  families,  but  he  declined  it  only 
until  the  disorder  had  gone  fairly  through  his  own  family,  and 
until  some  of  them  had  been  inoculated  by  Dr.  Aspinwall,  and 
otherwise  exposed  to  the  Small  Pox.  But  having  now  confirmed 
his  assertion,  that  the  Kine  Pox  protects  the  constitution  from  the 
infection  of  the  Small  Pox,  by  a  fair  experiment,  he  is  ready  to  attend 
them  whenever  they  choose.  Those  who  live  in  Boston  may  rest 
assured,  that  from  the  proximity  of  his  residence  to  the  capital,  he 
shall  make  such  arrangement  as  to  be  able  to  attend  them  as 
punctually  as  if  he  resided  there." 

The  new  inoculation  was  shortly  afterwards  tested 
on  a  large  scale.  A  Dr.  S.  obtained  lymph  from  a 
sailor,  who  had  arrived  at  Marblehead  from  London, 
and  was  supposed  to  be  suffering  from  Cow  Pox, 
but  in  reality  had  Small  Pox.  Dr.  S.  began  to 
use  it,  and  produced  an  epidemic  of  Small  Pox. 
Previous  to  this  accident  Dr.  D.  had  inoculated 
about  forty  persons  from  the  arm  of  Dr.  Water- 
house's  son,  and  all  who  had  been  vaccinated  took 
the  Small  Pox,  either  casually  or  by  inoculation, 
one    excepted.^ 

According    to    Baron — 

''  The  occurrences  at  Marblehead  led  Dr.  Waterhouse  to  believe 
that  the  vaccine  virus  had  degenerated." 

Waterhouse    wrote     to     Lettsom,    begging     him     to 

•Waterhouse.  A  Prosfect  of  Exterminating  the  Small  Pox.  Part  II., 
p.  10.     1800. 


4^8  INTRODUCTION  OF   VACCINATION. 

apply  to  Jenner  for  a  fresh  supply  of  lymph, 
pointing  out  that  he  had  gained  some  credit  by 
following  Dr.  Jenner's  footsteps,  and  that  he  turned 
to    him    for    further    assistance. 

"  A  letter  from  him,  should  he  allow  me  to  publish  it  or  any  part 
of  it,  might  set  this  benevolent  business  a-going  again  next  spring. 
Could  I  likewise  say  to  the  American  public  that  I  had  received 
matter  from  Dr.  Jenner  himself,  it  would  have  a  very  good  effect 
indeed." 

In  the  meantime  the  Americans  were  made  to 
wait   by    a   little    stratagem. 

Waterhouse    wrote    to    Jenner — 

"  1  gave  out  that  the  winter  was  an  unfavourable  season  for  this 
new  inoculation,  and  by  that  means  1  suspended  the  practice 
throughout  the  country  from  that  period  until  the  arrival  of  fresh 
matter  and  your  letter.  Now  we  are  going  on  again,  but  not  with 
the  faith  and  spirit  of  the  last  season.  Some  unlucky  cases  have 
damped  the  ardour  of  a  people  who  received  this  new  inoculation 
with  a  candour,  liberality,  and  even  generosity,  much  to  their 
credit." 

The  new  inoculation  was  not  introduced  without 
some  opposition,  but  Waterhouse  ^  succeeded  in 
establishing    the    practice, 

"  The  characters  in  America  most  distinguished  for  wisdom  and 
goodness  are  firm  believers  in  your  doctrine.  They  are  not,  how- 
ever, over-forward  in  assisting  me  against  this  new  irruption  of 
the  Goths.  1  do  not  wish  them  to  do  more  than  make  cartridges, 
or  at  least  hand  them.     At  present  they  leave  me  too  much  alone, 

'  Extract  of  a  letter  from  Dr.  Waterhouse  to  Dr.  Jenner,  dated 
Cambridge  (America),  November  5th,   1801.     (Baron,  loc.  cit.) 


FOREIGN  COUNTRIES.  429 

and  it  is  probable  will  only  come  openly  to  my  assistance  when  I 
do  not  tvant  them.  Had  I  not  a  kind  of  apostolic  zeal  I  should  at 
times  feel  a  little  discouraged.  The  natives  of  America  are  skilful 
in  bush-fighting." 

Cow  Pox  inoculation  was  introduced  into  America 
on  the  strength  of  one  doubtful  experiment,  and,  as 
on  the  Continent,  under  the  impression  that  it  was 
variolar    vaccinae    or    Small   Pox   of  the   Cow. 

Thus  were  the  scientists  in  Europe  and  America 
deceived.  They  were  led  to  believe  that  this  English 
disease  was  commonly  known  as  Cow  Small  Pox, 
whereas  it  was  Jenner  who  first  named  it  Cow  Small 
Pox.  It  was  really  known  in  England  as  "the  Pox 
among  Cows,"  or  the  "  Cow  Pox."  I  shall  again 
refer  to  this  subject  in  the  next  chapter. 


CHAPTER    XVI. 

PROGRESS    OF  VACCINA! TON  IN  ENGLAND. 

I  HAVE  already  dealt  with  the  life  and  letters  of 
Edward  Jenner,  from  the  study  of  which  an  insight  may 
be  obtained  into  the  history  of  vaccination  in  England 
up  to  the  year   of  Jenner's   death   (1823). 

Before  passing  on  to  the  period  which  followed,  I 
will  point  out  how  it  was  that  after  Cow  Pox 
inoculation  had  been  adopted  by  the  profession  in  this 
country,  the  doctrine  of  Cow  Small  Pox  came  to  be 
considered  as  essential.  It  will  no  doubt  be  a  sur- 
prise to  many  to  learn  the  origin  of  the  theory  that 
Cow  Pox  is  modified  Small  Pox,  as  it  is  so  universally 
rerarded  as  the  outcome  of  clinical  observations  and 
pathological  experiments.  To  explain  this  point  fully, 
I  will  again  refer,  and  at  some  length,  to  the  assump- 
tion,  by  Jenner,   of  the  term  variola:  vaccincB. 

The  title  of  Jenner's  original  paper  was  "  On  the 
Cow  Pox,"  but  in  the  published  Inquiry  he  inserted 
the  words,  variolcB  vaccincB.  Whether  this  term  was 
invented     by     Jenner     himself,     or     whether     it     was 


PROGRESS   OF   VACCINATION  IN  ENGLAND.        431 


suggested  by  one  of  the  friends  to  whom  he  had 
shown  his  manuscript,  history  does  not  relate.  At 
any  rate,  Jenner  made  himself  responsible  for  it  ;  and 
it  is  therefore  necessary  to  investigate  his  views  as  to 
the  relation  which  was  supposed  to  exist  between  the 
two  diseases.  In  the  first  place,  the  statement  which 
has  been  recently  made,  that  Jenner  believed  that 
Cow  Pox  was  derived  from  human  Small  Pox,  and 
hence  that  the  term  variolce  vaccince  was  justifiable, 
is  entirely  without  foundation.  The  facts  of  the  case 
are,  that  Jenner  believed  that  the  Cow  Pox  was 
derived  from  the  diseased  heels  of  the  horse  ;  he  also 
believed  that  Small  Pox  and  some  other  diseases  arose 
from  the  same  source.  When  the  boy  Phipps  was 
inoculated  with  Cow  Pox,  Jenner  was  struck  with 
the  similarity  to  some  cases  of  inoculated  Small  Pox, 
and  he  felt  convinced  that,  at  least,  Cow  Pox  and 
Small  Pox  were  derived  from  the  same  source.  The 
idea  that  Cow  Pox  arose  through  the  agency  of 
milkers  suffering  from  human  Small  Pox  never 
occurred  to  Jenner. 

Jenner's  theory  of  the  origin  of  Cow  Pox  from 
horse  grease  was  well  known  to  his  contemi)oraries. 
According  to  Fraser,  Woodville  strongly  objected  to 
it,  and  recommended  Jenner  to  omit  it  from  his 
original  paper. 

"  I  deeply  regret  that  he  did  not  follow  the  advice  which  Dr. 
Woodville  gave  him  upon   being  requested  to  peruse   the   nianu- 


432        PROGRESS   OF   VACCINATION  IN  ENGLAND. 


script  of  his  first  treatise  on  this  subject,  prior  to  its  publication. 
The  part  which  Dr.  Woodville  objected  to,  was  the  opinion 
broached  relative  to  the  origin  of  this  disease,  than  which  nothing 
can  be  more  contrary  to  philosophy,  analogy,  and  experiment." 

Pearson  ^  also  criticised  the  term  which  Jenner  had 
substituted   for   Cozv  Pox. 

"  For  the  sake  of  precision  in  language,  and  of  consequence, 
justness  in  thinking,  and  considering  that  there  is  no  way  of 
disabusing  ourselves  from  many  of  the  errors  of  physic,  but  by 
the  use  of  just  terms,  it  is  not  unworthy  of  our  attention  to  guard 
against  the  admission  of  newly  appropriated  names  which  will 
mislead  by  their  former  accepted  import. 

"  Variola  is  an  assumed  Latin  word,  and  its  meaning  will  be 
popularly  understood  in  the  English  tongue  by  saying  that  it  is 
a  name  of  a  disease,  better  known  by  another  name — the  Small 
Pox.  Granting  that  the  word  *  Variola '  is  a  derivative  from 
Varius  and  Varus  used  by  Pliny  and  Celsus  to  denote  a  disease 
with  spots  on  the  skin,  the  etymological  import  of  Variola  is  any 
cutaneous  spotted  distemper  ;  but  one  of  the  most  formidable  and 
distinct  of  the  cutaneous  order  is  what  is  called  the  Small  Pox, 
and  therefore,  as  I  apprehend,  the  name,  Variola  has  been  used 
technically  (/car  e^0K')(rjv)  to  signify  this  kind  of  spotted  malady, 
and  no  other. 

"  Now  as  the  Cow  Pox  is  a  specifically  different  distemper  from 
the  Small  Pox  in  essential  particulars,  namely,  in  the  nature  of 
its  morbific  poison,  and  in  its  symptoms, — although  the  Cow  Pox 
may  render  the  constitution  not  susceptible  of  the  Small  Pox, — it 
is  a  palpable  catachresis  to  designate  what  is  called  the  Cow  Pox 
by  the  denomination  Variola;  vaccines;  for  that  is  to  say,  in 
English,  Cow  Small  Pox,  and  yet  the  Cow  is  unsusceptible  of 
infection  by  the  variolous  poison." 

It  is  interesting  to  note  that  after  the  publication  of 
Pearson's   pamphlet,    and    after    the    discovery   of  cases 

Vol.  ii.,  p.  87. 


PROGRESS   OF   VACCINATION  IN  ENGLAND.        433 


of  Cow  Pox  arisino;  independently  of  horse  "  grease," 
Jenner  avoided,  for  a  time,  any  further  reference  to 
the  origin  of  the  disease. 

It  was  Fraser^  who  was  led  by  the  term  variolce 
vaccina:  to  regard  Cow  Pox  as  modified  Small  Pox. 
After  setting  aside  the  Jennerian  theory,  that  Cow 
Pox  is  modified  horse  grease,    P"raser  wrote  : — 

''  My  own  opinion  of  the  origin  of  this  disease  is  certainly 
original,  and  I  beheved  till  lately  that  it  was  also  singular ;  but 
my  learned  friend,  Dr.  James  Simms,  has  broached  the  same  idea 
in  a  paper  read  before  the  Medical  Society  of  London,  and  pub- 
lished in  the  last  volume  of  their  memoirs.  I  believe  that  the 
Small  Pox  and  the  Cow  Pox  are  one  and  the  same  disease  under 
different  modifications;  and  I  have  found,  in  course  of  conversation 
with  some  of  the  most  eminent  medical  and  chirurgical  doctors 
in  the  metropolis,  that  after  having  attentively  listened  to  many 
of  the  arguments  which  may  be  fairly  adduced  in  favour  of  this 
opinion  they  have  appeared  often  to  incline  to  the  same  belief. 
I  am  aware  that  the  proposition  may  be  considered,  by  some, 
equally  fanciful  and  absurd  with  Dr.  Jenner's,  but  at  the  same 
time  let  them  remember  that  it  is  at  least  supported  by  analot^y, 
philosophy,  and,  of  course,  probability,  although  not  in  the  present 
state  of  our  knowledge  by  experiment.  I  do  not  intend  to  insist 
upon  this  doctrine  as  incontrovertible,  nor  even  to  enter  largel}', 
at  present,  into  its  merits  with  a  view  of  establishing  it,  but  shall 
content  myself  with  observing  that  such  a  circumstance  would 
answer  the  most  important  and  useful  purposes." 

Before  seeing  what  those  useful  purposes  were,  it  is 
as  well  to  mention  that  PVaser  concluded  this  paper 
by  asserting  that  his  view  was  established  on  the 
"  solid    and     imperishable    foundation    of    truth ; "     but, 

'  Henr>' Fraser,  M.D.     Observatiuns  on  Vaccine  hioculation.    \'6o^- 
VOL.    I.  28 


434        PJ^ OGRESS   OF   VACCINATION  IN  ENGLAND. 


however     carefully     one     may     read     his  memoir,     no 

evidence    can    be     found     in     support    of  his    doctrine. 

Nevertheless,     he    adopted    the     theory,  and    pointed 

out     the     following     as     the     two     great  reasons     for 
believing  it  : — 

"  Firstly,  It  would  render  the  practice  of  vaccine  inoculation 
general  by  reconciling  the  minds  of  the  people  who  are  now 
imposed  upon  and  intimidated,  and  in  fact  shocked  at  the  idea  of 
its  filthy  ancestry. 

"  Secondly,  It  would  place  Dr.  Jenner's  discovery  upon  a  rock 
by  depriving  the  antagonists  of  vaccination  of  their  only  successful 
line  of  argument." 

Thus  the  assumption  that  Cow  Pox  exercised  a 
specific  effect  on  the  constitution,  rendering  it  proof 
against  Small  Pox,  led  to  the  invention  of  an  ingenious 
theory,  which  satisfied  the  minds  of  those  who  were 
willing  to  accept  a  plausible  explanation,  though  it  was 
opposed  to  all  practical  knowledge  of  the  disease  in 
the   Cow. 

But  the  great  question,  after  all,  was  whether  this 
disease  did  or  did  not  protect  from  Small  Pox  ;  and  there 
were  two  ways  in  which  this  was  put  to  the  test.  Were 
persons  after  vaccination  insusceptible  of  inoculation 
with  Small  Pox,  and  were  they  proof  against  exposure 
to  infection  ?  A  suftlcient  answer  to  the  first  question 
is  the  fact  that  Jenner  discountenanced  the  variolous 
test  as  unfair,  and  it  is  therefore  unnecessary  to  detail 
the  cases  in  which  inoculation  of  Small  Pox  succeeded 
after  vaccination.       With   regard    to    the    test    of  expo- 


PROGRESS  OF   VACCINATION  IN  ENGLAND. 


4,i5 


.sure  to  infection,  evidence—especially  towards  the  last 
few  years  of  Jenner's  life— was  equally  overwhelininn- ; 
but  the  failures  were  attributed  to  the  use  of  inijiroper 
lymph,  or  to  badly  or  inefficiently  performed  vaccina- 
tion, or  -the  Small  Pox  was  regardc-d  as  malignant 
Chicken  Pox.  The  reports  of  these  fiilures  proved 
a  crushing  blow  to  Jenner.  Never  before  was  he 
involved  in  so  many  perplexities  ;  he  even  .seemed 
ready  to  acknowledge  that  the  "  spontaneous  "  Cow 
Pox  which  Pearson  and  W'oodville  had  led  him  t(j 
pronounce  as  a  source  of  genuine  ''vaccine"  was, 
after  all,  of  no  value  ;  and  it  would  appear  as  if  he 
were  preparing,  just  before  his  death,  to  fall  back  upon 
horse  grease  as  the  only  source  of  the  "true  lifo 
preserving  fluid,"  although  in  his  earlier  researches 
he  had  satisfied  himself  that  equine  lymph  was  of  no 
value.  With  regard  to  the  instances  of  the  inefficacy 
of  Cow  Pox  which  were  brought  to  Jenner's  notice,  I 
will  give  a  short  account  of  Dr.  Alexander  Monro's ' 
observations  ''  on  Small  Pox  after  perfect  vaccination.  ' 
Dr.  Monro  wrote  : — 

"  Ever  since  the  publication  of  Dr.  jenner's  discovery 
respecting  the  Cow  Pox,  there  have  been  various  rumours 
afloat  of  Small  Pox  occurring  after  Cow  Pox.  In  consequence 
of  the  experience  which  I  myself  have  had  as  to  the  anti- 
variolous  effects  of  Cow  Pox,  I  confess  I  was  led  to 
suspect    that  some   mistake    had    been    committed,    either    as    to 

'  Monro.     Observations  oti  the  Different  Kinds  of  Small  Pox.    p.  144. 

i8i8. 


436        PROGRESS   OF   VACCINATION  IN  ENGLAND. 


the  nature  of  the  disease,  or  as  to  the  previous  vaccination. 
At  length,  about  nine  years  ago,  all  doubt  from  my  mind 
was  removed,  in  consequence  of  my  having  had  ocular  and 
very  distinct  evidence  of  perfect  vaccination  having  failed  to 
produce  the  promised  security." 

Dr.  Monro  not  only  made  his  own  observations, 
but  he  corresponded  with  other  members  of  the  pro- 
fession. Mr.  Cooper  informed  him  that  "  cases  of 
Small   Pox   after  Cow  Pox  are  now  daily   occurrences." 

The  statements  made  by  Dr.  Alexander  Ramsay, 
of  Dundee,  were  still  more  striking.  In  a  letter  to 
Dr.  Monro,  dated  27th  June,  18 18,  Dr.  Ramsay 
said  : — 

"  Though  our  confidence,  no  doubt,  is  limited,  yet  it  (vacci- 
nation) does  appear  to  us  of  great  value,  and  to  possess  many 
advantages  over  variolous  inoculation.  We  are  inclined  to 
think  that  much  depends  on  effecting  the  vaccine  disease  in 
its  most  perfect  form,  and  preserving  the  pustule  entire,  which 
hitherto  has  not  been  the  case. 

"  It  must,  indeed,  be  admitted  that  facts  do  not  bear  us  out 
fairly  in  the  conclusion  that  vaccination  has  resisted  the  attack 
of  this  eruptive  disease  in  proportion  to  the  perfection  of  its 
character.  On  the  contrary,  several  of  the  most  distinctly 
marked  cases  of  Small  Pox  have  occurred  in  those  who  have  been 
vaccinated  apparently  in  the  most  satisfactory  manner,  and  where  the 
celhilated  marks  on  both  arms  are  still  as  perfect  as  possible. 

"  In  most  cases,  however,  the  pustules  had  not  been  pre- 
served entire,  but  in  several  they  were  so  ;  and  in  those  no 
circumstance  whatever  could  be  found,  on  the  strictest  exami- 
nation, to  invalidate  the  evidence  of  Small  Pox  in  its  perfect 
form  having  succeeded  to  vaccination  in  its  perfect  form." 

After  this  independent  testimony,  Dr.  Monro  described 


PROGRESS   OF   VACCINATION  IN  ENGLAND. 


437 


the  cases  in  his  own  family,  and  not  the  least  strikino- 
incident  in  their  history  is  the  fact  that  tlu^y  had  l)ecn 
vaccinated  by   Mr.    Bryce,  and   submitted   to  his  test. 

The  first  case  was  Dr.  Monro's  eldest  son.  acred 
Iifteen. 

"  He  had  been  vaccinated,  according  to  my  father's  notes, 
on  the  left  arm  by  Mr.  Bryce  with  Cow  Pox  matter,  on 
Saturday,    October   29th,    1803." 

Fitleen  years  afterwards,  the  bo)-  caught  .Small  Pox. 
The  following  is  the  lull  history  of  the  case  : — 

"Edinburgh,  Febniary  2%//i,    1818. 

"  A.  M.,  aet.  fifteen,  was  this  morning  seized  with  headache, 
lassitude,  drowsiness,   and   considerable   general   oppression. 

"  He  went  to  church,  but  on  returning  home  from  the  morning 
service  was  still  more  oppressed ;  his  face  was  much  flushed, 
and  his  eyes  red ;  had  severe  headache ;  was  very  drowsy ; 
threw  himself  on  the  sofa,  where  I  found  him  sleeping  at 
one  o'clock   wu. 

"His  skin  was  then  hot;  pulse  but  little  affected;  had  no 
appetite,  and  took  no  dinner.  In  the  evening,  his  pulse  became 
qTjick  ;  he  was  more  flushed ;  eyes  redder,  and  headache  more 
severe.  Got  5!  of  the  compound  powder  of  jalap.  Passed  a 
very  restless  night ;  frequently  started  up,  and  talked  a  great 
deal  in  his  sleep. 

''Monday. — Pulse  no.  Still  more  flushed  and  oppressed; 
had  hot  and  cold  fits.  Had  a  stool  from  the  jalap,  which  was 
natural  as  to  colour  and  quantity.  Was  frequently  sick  ;  10 
grains  of  ipecacuanha  were  prescribed.  Vomited  freely  a  con- 
siderable quantity  of  yellow-coloured  fluid  like  bile.  Passed  a 
still  more  restless  night  than  the  preceding,  and  talked  a  great 
deal  in  his  sleep.     Was   occasionally  sick  during   the   night. 

''  Tuesday.— VviXsG  120.  Skin  hotter;  face  still  more  flushed 
and  swollen  ;  more   thirsty  ;    tongue   white ;    complained  of  cold. 


438        PROGRESS   OF   VACCINATION  IN  ENGLAND. 

No  stool.     Got  5!  of  compound  powder  of  jalap  and  4  grains  of 
calomel.     Complained  much  of  coldness  of  the  feet. 

"  Wednesday  {\st  day  of  entptioii). — Skin  hot  and  red  ;  much 
thirst ;  had  three  or  four  stools  from  the  medicine.  He  sneezed 
frequently.  There  are  several  small,  red,  round  spots,  like  a 
flea-bite,  on  the  back  of  the  left  hand,  and  on  the  little  finger, 
and  also  on  the  forehead  ;  the  red  colour  of  which  is  not 
removed  b}'  pressure,  and  pressure  is  painful.  Tongue  white ; 
still  complained  much  of  cold,  especially  of  the  extremities. 
There   is  a  slight  moisture  on  the  face.     Pulse   120. 

"  Thursday  (2nd  day  of  entptioii). — The  number  of  red  spots 
on  the  forehead  is  now  much  greater,  and  there  are  also  a 
number  on  the  cheeks,  nose,  ears,  lips,  arms,  and  legs  ;  the 
skin  between  these  is  of  a  florid  red  colour.  The  cheeks  and 
eylids  are  swelled  and  red.  Eyes  slightly  inflamed  ;  he  cannot 
bear  the  light,  and  sneezed  a  good  deal.  Pulse  60.  Passed 
a  good  night.  Little  appetite.  Starting  in  sleep ;  much  dis- 
turbed  b}'   dreaming,    and   talked  a  great  deal  during  his   sleep. 

"  Friday  (third  day  of  eruption). — The  red  spots  on  the  skin  are 
considerably  broader,  and  not  of  uniform  size  over  the  whole 
body,  nor  equally  prominent ;  those  on  the  face  and  neck  are 
farthest  advanced.  Each  spot  has  a  distinct  red  line  round  its 
basis ;  in  the  centre  of  many  of  those  on  the  face,  neck,  and 
breast-bone,  there  is  a  small  quantity  of  a  serous  fluid,  with  a 
depression  in  the  centre.  Eyes  more  inflamed,  and  more  tender. 
There  are  a  number  of  pimples  among  the  hair,  especially  on  the 
back  of  the  head,  which  are  ver}^  itchy.  Had  a  good  deal  of 
sneezing.  Tried  to  sit  up,  but  it  produced  acute  headache,  and 
he  could  not  do  so  above  ten  minutes.  Has  slight  soreness  of 
his  throat,  which  he  refers  to  the  larynx.  Has  no  difficulty  in 
swallowing.  Several  pustules  on  the  face  have  run  together. 
No  stool.  A  tablespoonful  of  syrup  of  senna  was  prescribed  at 
1 1  o'clock  A.M.,  and  a  second  similar  dose  given  at  half-past  1 1 
at  night. 

"  Saturday  (fourth  day  of  eruption). — Nearly  in  the  same  state 
as  yesterday.     Had  three  or  four  loose  stools  from  the  medicine. 

"  Sunday  {fifth  day  of  eruption). — Passed  a  good  night ;  no 
thirst ;  no  fever.      He  had  a  free  motion  in  the  morning.    Appetite 


PROGRESS   OF    VACCIXATION  IX  /-XGLAXD. 


AV* 


improved.  The  pimples  on  the  face  and  lobe  of  the  ears  are  of 
different  sizes,  and  filled  by  a  watery  fluid.  The  transparent 
vesicles  have  distinct  necks,  and  are  very  like  blisters  occasioned 
by  boiling  water. 

"  I  conceive  that  the  transparent  vesicles  were  formed  on  the 
top  of  the  original  pimples.  Dr.  Rutherford,  however,  holds  a 
different  opinion  as  to  the  origin  of  the  transparent  vesicles,  and 
supposed,  that  in  consequence  of  inflammation  of  the  skin,  a 
serous  fluid  was  suddenly  effused  under  the  scarf  skin,  and  formed 
vesicles  at  the  side  of  the  Small  Pox  pimples. 

"The  vesicles  filled  by  transparent  water  are  more  numerous 
on  the  face  than  those  filled  by  pus,  for  there  are  not  above  hall" 
a  dozen  of  pustules  on  the  face  filled  by  pus,  which  have  a 
manifest  depression  in  the  centre.  The  pimples  on  the  breast, 
those  on  the  back,  arms,  thighs,  and  legs,  are  exactly  like  the 
pimples  of  the  Small  Pox,  and  are  filled  with  pus.  The  progress 
of  the  pimples  on  the  face  has  been  quicker  than  that  of  those 
nearer  to  the  centre  of  circulation.  The  pimple  over  the  breast- 
bone, which  had  made  the  greatest  progress,  was  punctured  with 
a  lancet  by  Mr.  Bryce,  and  was  found  to  contain  pus  ;  and  Mr. 
Bryce  said,  he  had  no  doubt  but  that  it  would,  by  inoculation, 
communicate  the  Small  Pox. 

"  Skin  not  so  itchy  to-day.  The  vesicles  which  were  filled  b}- 
a  watery  fluid,  in  the  course  of  four  or  five  hours  lost  considerably 
of  their  prominence,  were  less  tense,  and  wxre  by  no  means  so 
transparent,  and  seemed  filled  with  whey,  and  some  of  them  burst 
on  turning  the  head  and  pressing  on  them.  This  day,  Mr.  Lizars 
made  a  drawing  from  the  face,  which  conveys  a  more  accurate 
idea  of  the  appearances  than  verbal  discription.  (Vide  Plate  111.) 
Got  at  12  o'clock  p.m.  a  tablespoonful  of  syrup  of  senna. 

"  Monday,  March  2nd  (sixth  day  of  eruption). — Slept  a  good  deal 
yesterday  afternoon  ;  passed  a  good  night ;  took  his  breakfast  with 
appetite.  The  pustules  on  the  face  are  not  so  tense  as  yesterday 
The  medicine  has  operated  twice.  No  thirst ;  no  fever.  The 
pimples  on  the  arms  and  legs  are  now  become  pustular,  and  Dr. 
Rutherford  and  Mr.  Bryce  think  them  perfectly  like  those  of  Small 
Pox.  Mr.  Bryce  punctured  one  of  them,  which  was  found  to  be 
filled  with  thick  viscid  pus.     The  cuticle  over  the  pimples  on  the 


440        PROGRESS   OF   VACCINATION  IN  ENGLAND. 


arms  and  legs  is  thicker  than  that  of  those  of  the  face ;  and  hence 
the  pustules  are  more  of  a  grey  colour.  The  cuticle  of  those 
vesicles  of  his  face  which  are  filled  with  a  watery  fluid,  is 
shrivelled,  of  a  yellow  colour,  and  in  some  of  them  there  are 
a  few  opaque  white  spots.  Many  of  the  pimples  on  the  leg  seem 
to  have  gone  back.  The  face  and  legs  are  now  less  swelled. 
The  spaces  between  the  pustules  of  the  face  are  less  red  than 
yesterday. 

"  I  observed  about  nine  in  the  evening,  that  the  vesicles  on 
the  face  which  had  been  filled  by  a  transparent  fluid,  had  shrunk 
very  considerably.  Pulse  6o.  Was  at  nine  in  the  evening  in 
a  sound  sleep,  from  which  he  did  not  awake  though  a  candle  was 
held  near  to  his  eyes.      Pulse  64. 

"  Tuesday,  March  ^rd  [seventh  day  of  eruption).— Y'^ss&d  a  good 
night.  Pulse  60,  and  regular.  The  greater  number  of  the  larger 
vesicles  which  contained  the  clear  fluid  have  burst.  On  some 
of  them,  the  scarf-skin  is  much  shrivelled,  and  these  are  filled  by 
a  small  quantity  of  yellow  fluid.  No  stool.  Eyes  less  tender. 
There  is  now  but  little  redness  on  the  skin  of  the  body  between 
the  pimples. 

"  The  progress  of  the  pimples  has  been  very  irregular  ;  those 
on  the  left  hand  are  to  the  touch,  hard,  and  of  a  light  grey  colour, 
though  they  first  appeared.  The  progress  of  these  pimples  has 
not  been  nearly  so  rapid  as  of  many  in  other  parts  of  the  body. 
On  one  of  them  being  opened,  it  was  found  to  contain  purulent 
matter.  Many  of  the  smallest  pimples  on  every  part  of  the  body 
have  gone  back,  and  on  pressing  the  skin,  no  hardness  is  per- 
ceptible. The  pimples  on  the  breast  have  not  gone  on  to 
suppuration  faster  than  those  of  the  extremities  of  the  body. 

"  There  is  a  diffused  redness  between  the  pimples  on  the 
extremities,  but  it  never  was  so  great  as  between  the  pustules  on 
the  face. 

"  None  of  the  pimples  which  resembled  those  of  Small  Pox 
were  above  a  quarter  an  inch  in  diameter,  and  many  as  small  as 
pin  points. 

"  Mr.  Syme  made  his  drawing  between  ii  and  12  o'clock  from 
the  pustules  on  the  left  arm,  and  also  of  the  one  on  the  back  of 
the  hand. 


FROGRJ£SS  OF   VACCINATION  IX  ENGLAND.        441 

"  No  headache,  thirst,  or  heat  of  skin. 

"  Wednesday,  March  ^lli  (eighth  day  of  eruption). — Passed  a 
good  night.  Pulse  64.  Skin  cool  ;  no  thirst.  A  small  crust  of  a 
deep  brown  colour  is  formed  over  many  of  the  pustules ;  in  a  few 
on  iiis  forehead,  there  is  no  matter.  The  skin  between  the  pimples 
of  the  face  is  now  of  the  natural  colour,  and  the  swelling  of  face 
and  lips  is  gone.  The  pimples  on  the  left  hand  and  fingers  which 
appeared  first  are  still  of  a  grey  colour,  feel  hard,  are  painful  when 
pressed,  and  there  is  no  matter  now  in  them  ;  but  there  are  other 
pustules  on  the  back  of  the  hand  which  evidently  still  contain 
matter.  Mr.  Bryce  opened  one  of  them,  and  found  it  filled  by 
very  viscid  yellow  matter.  Many  of  the  pimples  on  both  thighs 
are  still  filled  by  matter  ;  in  the  centre  of  others,  there  is  a  slight 
scale,  which  gives  the  appearance  as  if  the  pustules  were  depressed 
in  the  middle.     Skin  still  very  itchy. 

"  Thursday,  March  ^fli  {ninth  day). — Passed  a  very  good  night. 
Appetite  to-day  very  keen.  Pulse  60.  The  greater  number  of 
the  pustules  have  now  dried  up ;  there  are,  however,  still  a  few 
containing  purulent  matter  upon  the  hands  and  thighs.  The 
crusts  of  the  pimples  on  the  face,  which  resembled  the  blisters 
from  burns,  are  of  a  light  yellow  colour,  and  are  surrounded  by 
crusts  of  a  dark  brown  colour  formed  on  the  pustules,  which 
resembled  those  of  Small  Pox.  Many  of  these  crusts  on  the  face 
have  now  fallen  off,  but  the  skin  under  them  is  rough,  and  slightly 
elevated.  Dr.  Rutherford  supposes  that  a  little  crust  was  formed 
upon  the  skin  after  the  larger  crusts  had  fallen  off. 

''Friday,  March  6th  {tenth  day).  —  Passed  a  good  night- 
Pulse  64.     No  headache;   no  thirst;   appetite  good. 

'' Saturday,  March  yth  {eleventh  day).— AW  the  pimples  are  now 
dry  in  the  outer  layers.  A  great  many  of  the  dry  crusts  have 
fallen  off.  On  drawing  the  fingers  along  the  skin,  there  is  an 
evident  elevation  where  the  pimples  were ;  for  a  few  of  the  layers 
of  the  dried  vesicles  still  remain.  Pulse  natural  ;  no  Jieadache  ; 
feels  himself  now  much  stronger. 

''Sunday,  March  Sth  {twelfth  day).— The  crusts  still  continue 
on  the  face,  and  those  on  the  thighs,  arms,  and  hands  have  a 
considerable  degree  of  hardness  and  transparency.  Is  in  all  other 
respects  quite  well. 


442        PROGRESS   OF    VACC/NATJO^'  lA^  EA'GLANB. 


"Saturday,  March  i^tli  (eighteenth  day  of  criiptioit). — There  are 
still  some  crusts  on  his  face,  and  a  great  many  on  the  thighs, 
arms,  and  hands,  though  he  took  the  warm  bath  last  night. 
There  are  three  very  evident  pits  of  a  triangular  form  on  the  left 
temple,  the  bottom  of  which  is  very  irregular.  The  cuticle  over 
the  crusts  on  the  hands  has  burst,  and  now  forms  a  white  line 
around  the  basis  or  rather  circumference  of  the  dried  crust. 

"March  lyth. — Many  of  the  crusts  on  the  extremities  of  the 
body,  and  especially  those  on  the  arms,  have  not  fallen  oft'. 

^^  March  igth  (tiventy-first  day  since  eruption  appeared). — There 
are  still  many  of  the  crusts  on  the  arms  and  legs. 

'^  March  22nd  {the  twenty-second  day  since  tlie  eruption  appeared). 
— Three  pimples  of  different  sizes,  and  in  different  states  of 
progress,  were  observed  to-day  on  the  right  thigh,  and  at  no 
great  distance  from  each  other.  One  was  like  a  flea-bite,  of  a 
pale  red  colour,  and  felt  globular  when  the  finger  was  drawn 
along.  A  second  has  a  circle  of  a  deeper  red  within  the  paler  red, 
and  there  is  a  clear  spot  on  the  top ;  in  a  third,  the  crimson  ring  is 
still  more  apparent,  and  the  centre  of  it  seem.s  filled  with  a  liquor 
like  whe}',  evidently  depressed,  and  had  every  appearance  of  the 
genuine  Small  Pox  pimples. 

"  March  2'i^rd. — The  pimples  which  have  appeared  on  the  thigh 
continue  to  follow  the  usual  course  of  the  pimples  of  the  modified 
Small  Pox. 

"  A  number  of  crimson-coloured  blotches  appeared  on  the  skin 
after  the  crusts  fell  off",  and  these  were  not  obliterated  at  so  late  a 
period  as  the  2nd  of  June.  During  the  progress  of  the  disorder, 
a  dish  with  nitrous  fumigation  was  constantly  kept  in  the  room." 

I    do   not   propose  to  quote   in   full   the  particulars   of 
the   other   cases  in   the   family,   but    the    history   of  the 
vaccination   is   important. 

"J.  M.  was  inoculated  in  his  left  arm  on  Wednesda}',  December 
17th,  1806,  when  three  months  and  three  days  old.  A  pustule 
has  formed,  about  one-sixth  of  an  inch  in  diameter,  which  is  red 
at  the  edges,  and  its  middle  rises  into  a  point,  from  which  matter 


PROGRESS   OF   ]'ACC1NAT10N  IN  ENGLAND.        443 


has  oozed  out,  and,  by  dr^'ing,  formed  a  ^'ellow  crust.  On  Monday, 
December  22nd,  1806,  five  days  after  the  inoculation,  Mr.  Brycc- 
inoculated  him  with  matter  from  his  left  arm  :  instead  of  laying 
the  lancet  flat  upon  the  arm,  and  rubbing  off  the  matter  while  the 
point  of  the  lancet  was  under  the  cuticle,  he  punctured  the  arm, 
with  the  point  placed  perpendicularly,  three  or  four  times. 

"  Ar^'/z/^rr  23;7/.— Thirty-two  hours  afterwards,  a  pimi^le  alxtut 
one-tenth  of  an  inch  in  diameter,  and  of  a  red  colour,  had  formed 
on  his  right  or  last  punctured  arm.  The  vaccination  was  at  the 
time  considered  complete." 

J.  M.,  set.  II,  Monday,  March  i6th.  1818.  suffered 
from  symptoms  which  developed  into  an  attack  of 
Small   Pox. 

The  third  child,  K.M.,  had  also  been  inoculated  with 
Cow  Pox,  and  tested  by  Mr.  Bryce,  and,  at  the  time, 
Mr.  Bryce,  and  Dr.  Monro  and  his  father,  regarded 
the  vaccination  as  perfect.  On  March  15th,  181S, 
K.M.,  ait.  thirteen,  had  symptoms  which  proved  to  be 
those   of  an  attack   of   Small   Pox. 

Among  other  cases  reported  to  Dr.  Monro,  was  the 
son  of  Dr.  Hennen.  This  boy  contracted  Small  Pox,  and 
at  first,  as  the  boy  had  been  vaccinated,  the  disttase  was 
considered  as  \'aricella.  But  the  source  of  infection  was 
a  soldier,  in  whom  the  disease  w^as  ascertained  to  Ijc 
Small   Pox.      Dr.    Hennen   wrote:— 

"This  boy  was  vaccinated  by  myself  when  three  months  old,  and 
I  had  every  reason  to  be  satisfied  with  the  genuineness  of  the 
matter  ;  he  has  often  been  exposed  to  variolous  contagion  in  Spain, 
France,  and  Portugal,  and  particularly  last  year  at  Portsmouth." 

Another  letter    of  great    interest    was    received    from 


444        PROGRESS   OF   VACCINATION  IN  ENGLAND. 


Dr.    Smith    of  Dunse,    2nd    June.    1818.       Dr.    Smith 
wrote  : — 

"  I  had,  indeed,  seen  several  cases  of  Small  Pox  supervening 
upon  vaccination,  which  I  mentioned  at  the  time  to  Dr.  Far- 
quharson  ;  but  as  he  seemed  to  think  lightly  of  them,  I  judged  it 
prudent  to  take  no  further  notice  of  the  circumstance.  Even 
now,  though  I  have  seen  a  multitude  of  cases  in  which  Small  Pox 
has,  in  every  possible  shape,  taken  place  after  vaccination,  I 
feel  myself  placed  in  the  painful  situation  of  bringing  forward 
many  facts  to  which  gentlemen  of  the  first  eminence  in  the 
profession  will  probably  give  little  or  no  credit.   .   .   . 

"  It  is  now  about  three  months  since  Small  Pox  appeared  in 
the  east  coast  of  Berwickshire,  particularly  at  Coldinghame, 
Eysmouth,  and  Ayton.  Several  3'oung  people,  who  had  not  been 
vaccinated  fell  victims  to  the  disease.  In  the  course  of  a  few 
weeks  afterwards,  this  pestilential  malady  extended  itself  over 
other  parts  of  the  country,  and  whole  families  were  in  consequence 
promiscuously  laid  up,  whether  vaccinated  or  not.  1  have  seen  a 
number  of  cases  wherein  great  crops  of  Small  Pox  took  place 
after  vaccination.  I  attended  two  in  particular  that  were  con- 
fluent, and  watched  the  progress  of  the  disease  with  much 
anxiety,  .  .  . 

"  I  am  perfectly  sensible  I  may  have  incurred  much  odium  in 
the  opinion  of  many  for  having  had  recourse  to  inoculation  after 
it  has  so  long  been  exploded.  .  .  .  Vaccination  either  does,  or  it 
does  not,  resist  the  variolous  affection.  If  the  former,  vaccination 
cannot  possibly  do  harm  ;  but,  i'i  the  latter,  we  are  imperiously 
called  upon  to  communicate  the  Small  Pox  in  the  mildest  way  we 
can,  and  not  leave  the  rising  generation  to  the  scourge  of  a 
loathsome  and  dangerous  disease." 

Practitioners  had  so  committed  themselves  to  a 
behef  in  the  protective  power  of  Cow  Pox  that 
even  when  Small  Pox  occurred  after  perfect  vaccina- 
tion     it     was     impossible     for     many     to     believe     it. 


FROGRIiSS   OF   J-ACCIXA770N  /jY  ENGLAND.        445 


The  dist^ase,  they  said,  must  Ije  Malignant  Cliicken 
Pox.  This,  for  example,  was  the;  view  takc:n  in  \\\v. 
case  of  a  boy  at  Inverness,  two  years  old.  who  had 
Small  Pox  "  after  having  passed  through  th(!  Cow 
Pox  in  its  most  perfect  state."  Put  Dr.  RoJjertson  set 
the  question  at  rest  by  inoculating  a  child,  and  the  child 
so  inoculated  not  only  had  the  common  Small  Vn\,  Init 
had  it  severely.  Dr.  Smith,  of  Dunse,  had  similar 
experiences,  and  "  repeatedly  practised  inoculation  with 
matter  taken  from  those  who  had  the  Small  Pox  after 
the   Cow   Pox." 

Dr.  Monro  was  unable  to  free  himself  from  his 
previous  convictions  in  regard  to  the  in-o])hylactic 
efficacy  of  Cow  Pox,  and  he  concluded,  that  the 
disease  was  milder  than  might  otherwise  have  been 
the  case. 

These  were  not  the  only  outbreaks  of  Small  Pox 
about  this  time  which  afforded  similar  experiences  ; 
and  it  is  not  surprising,  therefore,  that  Jenner  was 
surrounded   with   perplexities. 

X'acci  nation,  it  is  true,  was  in  a  great  measure 
discredited,  but  it  still  survived,  and  was  gradually 
reinstated.  This  was  due  partly,  no  doubt,  to  th(- 
favourable  reports  of  the  officials  of  the  National 
\'accine  Establishment  ;  but  the  re\i\al  was  certain))- 
brought  about  more  particularly  by  the  exertions 
of  J(^hn  lUiron,  the  friend  and  lMogra|)h(--r  ot' 
Jenner. 


446        PROGRESS  OF   VACCINA  7/0^  IN  ENGLAND. 

Jenner's  notes  and  correspondence  had  been  placed 
by  his  executors  in  Baron's  hands.  From  his  in- 
timate acquaintance  with  Jenner,  he  was  regarded  as 
the  most  suitable  person  to  prepare  a  biography.  All 
Jenner's  early  letters  were  bequeathed  to  Baron  by 
Edward  Gardner.  But  Baron's  object  was  not  merely 
to  write  a  biography  of  Jenner;  his  work  was  intended 
to  restore  the  shattered  credit  of  vaccination.  Thus 
he    wrote   in   the    Introduction  : — 

"  The  recent  prevalence  of  Small  Pox  in  different  parts  of 
Europe,  and  the  corresponding  diminution  of  confidence  in  the 
virtues  of  the  Variolae  Vaccinae  rendered  it  an  object  of  no  incon- 
siderable importance  to  endeavour  to  restore  and  increase  that 
confidence,  by  showing  that  Dr.  Jenner  clearly  foresaw  the 
deviations  which  have  been  observed  ;  that  his  doctrines,  if  pro- 
perly understood,  satisfactorily  account  for  them ;  and  that 
nothing,  in  fact,  has  occurred  which  does  not  strengthen  and 
confirm  his  original  opinions  both  with  regard  to  the  \'ariola 
and  the  Variolae  Vaccinae.  I  would  hope  that  something  may 
have  been  done  in  these  respects  that  shall  tend  to  promote  the 
universal  adoption  of  a  practice  capable  of  effecting  so  much  good. 

"  Nothing,  I  am  persuaded,  can  ever  accomplish  this  object 
except  a  real  knowledge  of  the  nature  of  that  affection  which  might 
be  made  to  lake  the  place  of  Small  Pox.  A  ver}'  sincere  wish  to 
accelerate  this  event  has  led  me  to  the  discussions  contained  in 
the  present  volume,  the  publication  of  which  at  this  time,  I  would 
humbly  hope,  may  not  be  without  its  use." 

No  one  can  posssibly  read  Baron's  Life  of  Jenner 
without  feeling  the  prejudices  and  the  strong  bias 
displayed  all  through  the  work ;  and  no  one  with 
any  knowledge  of  comparative  pathology,   can   possibly 


PROGRJt:SS  OF   VACCIXAT/ON  /A^  EArQLA.YD.        447 

Study  it  without  being  impressed  with  the  gross 
fallacies  to  which  Baron  committed  himself.  His 
historical  investigation,  as  I  have  already  pointed 
out,  resulted  in  proving  to  his  own  satisfiction  that 
Jenner's  Cow  Pox  was  the  remnant  of  an  outbreak 
of  Cow  Small  Pox.  and  thus  he  justified  the  term, 
variolce  vaccince,  and  endeavoured  to  establish  the  j)ro- 
tective  power  of  Cow  Pox.  Rut  his  elaborate  statement 
proved  to  be  a  tissue  of  l)lunders,  for  the  disease 
described  as  Cow  Small  Pox  had  nothing  to  do  with 
Cow  Pox  ;  it  was.  in  fact.  Cattle  Plague.  At  the  time, 
however.  Baron's  teachings  were  accepted,  and  thus  his 
blunders  fulfilled  his  purpose.  Criticised  in  the  light 
of  modern  information,  the  only  value  of  Baron's  work 
is  to  be  tbund  in  the  publication  of  Jenner's  corre- 
spondence, by  which  we  are  able  to  judge  of  the 
way  in  which  vaccination  was  conducted  from  1 798 
to    1823. 

Baron  employed  other  channels  for  spreading  his 
ideas,  and  he  so  far  succeeded  that  he  misled  the 
medical  profession.  Thus  he  was  made  Chairman 
of  a  Committee  of  the  Provincial  Medical  and 
Surgical  Association,  and  in  their  report,  signed,  and 
probably  entirely  written  by  the  Chairman,  the  patho- 
logical fallacies  in  Jenner's  biography  were  repeated 
in  a  description  of  the  affinities  between  Human 
Small  Pox  and  the  so-called  Cow  Small  Pox,  and  we 
are    told     that,    "  ui)on     a     due     understanding    ot     this 


4^8        PROGJ^ESS   OF   VACCINATION  IN  ENGLAND. 


portion  of  the  subject  everything  that  is  Vciluable  in 
the  practice  of  vaccination  depends,"  Then  follows 
an  elaborate  dissertation  on  the  disease  described  by 
Layard.  in  this  country,  and  by  Frascatorius,  Lancisi, 
Lanzoni,  Ramazzini,  and  others,  in  Italy,  in  other 
words,  on  Rinderpest  or  Cattle  Plague.  Thus  was  Cow 
Pox  dogmatically  asserted  to  be  Cow  Small  Pox;  and 
Eraser's  theory,  which  obscured  the  great  fallacy  in 
Cow  Pox  inoculation,  was  admitted  as  a  pathological 
fact. 

In  support  of  the  theory,  Baron  related  that  Mr. 
Bree,   of  Stowmarket,    had   written   to  say — 

"  During  the  prevalence  of  Small  Pox  in  this  neighbourhood, 
several  dairies  became  affected  with  Cow  Pox  ;  which  supports 
the  opinion  of  the  identit}^  of  the  two  diseases,  the  latter  being 
probably  modified   by  being  developed  in  the  cow." 

Baron  also  referred  to  a  statement  made  by  Dr. 
Waterhouse,   of   Massachusetts,   in  a  letter  to  Jenner. 

"  At  one  of  our  periodical  inoculations,  which  occur  in  New 
England  once  in  eight  or  nine  years,  several  people  drove  their 
cows  to  an  hospital  near  a  populous  village,  in  order  that  their 
families  might  have  the  daily  benefit  of  their  milk.  These 
cows  were  milked  by  persons  in  all  stages  of  Small  Pox. 
The  consequence  was,  the  cows  had  an  eruptive  disorder  on 
their  teats  and  udders,  so  like  the  Small  Pox  pustule,  that  every 
r)ne  in  the  hospital,  as  well  as  the  physician  who  told  me, 
declared  the  cows  had  the   Small   Pox." 

^Fhe  whole  of  this  anecdote  was  hearsa)'.  It  was 
|>roljably  a  coincident  outbreak   of  one  of  the  common 


PROGRESS  OF   1\4C(:/.VATI0.V  IN  EiVGLAJvo. 


•H9 


<jruptive  affections    of   the    teats  ;   and    so    little    interest 

was  taken  in  the  event  at  the  time,  that  no  inoculations 

were    made    from    the    cows   to  test    the    nature    of    the 

eruption.     And   yet   Baron  writes  : — 

"  It  is  impossible,  we  conceive,  to  doubt  the  fact  that  on 
this  occasion  the  Small  Pox  had  been  conveyed  from  man  to 
the  cow,  just  as  it  had  been  communicated,  in  the  dairies  of 
Gloucestershire,  from  the  cow  to  man." 

But  though  Baron  succeeded  in  carrying  the  general 
opinion  of  the  profession  in  favour  of  vaccination,  there 
were  individual  vaccinators  who.  occasionally,  spoke  out 
candidly  enough.^  Thus,  Estlin,  in  1837,  wrote  to 
the  editor  of  the  Medical  Gazette : — 

''  Allow  me,  in  the  first  place,  to  premise  that,  having  been 
engaged  in  vaccinating  (at  one  time  rather  extensively)  for 
tliirty  3'ears,  1  have  watched,  with  regret,  a  decided  decHne  in 
the  activity  of  the  virus ;  and  for  many  years,  I  have  been 
endeavouring  in  vain  to  renew  the  lymph  from  its  original 
source.  On  the  diminished  anti-variolous  power  of  the  present 
stock  of  vaccine  matter  I  need  make  no  remark ;  the  pubhc  are 
too  painfully  aware  of  the   fact." 

Badcock  -  was  led  to  undertake  his  experiments 
by   the   tbllowing   occurrence    in    1836: — 

''Towards  the  end  of  the  year  1836,  I  suffered  severely  from 
a  dangerous  attack  of  Small  Pox,  which  happened  but  a  few 
months  after  revaccination ;  and  my  mind  having  previously 
been  impressed  with  an  idea  that  the  old  vaccine  had  lost  its 
protective  influence   by  passing    through    so    many   constitutions 


'  Compare  Duncan  Stewart.     Report  on  Smnll  Pox  in  Calciitfa,  and 
Vaccination  in  Jicngal.     1827-44. 
-  Vol.  ii.,  p.  518. 

vor..  I.  29 


450        PROGRESS   OF   VACCINATfON  IN  ENGLAND. 


during  the  long  period  of  forty  years,  I  was  exceedingly  anxiou<^ 
to  procure  some  fresh  from  the  cow,  for  the  purpose  of  having 
my  own  children  revaccinated." 

And,  again,  speaking  of"  his  experiences   up  to    1845, 

Badcock  wrote  : — 

"  From  whatever  cause  it  may  arise,  the  fact  has  been  of 
late  years  already  ascertained,  that  the  ordinary  vaccine  virus 
has  lost  a  great  deal  of  its  protective  power  against  Small  Pox. 
A  greater  number  of  cases  in  which  that  disease  has  occurred 
after  vaccination  are  met  with  than  formerly,  and  in  some 
instances  those  are  very  severe,  and  occasionally  even  terminate 
fatally." 

In  fact,  an  alteration  in  the  quality  of  the  lymph 
had  now  become  one  of  the  stock  apologetics  for  Cow 
Pox  failures,  and  the  profession  was  still  persuaded 
to  believe  in  "  that  most  precious  boon  of  Jenner  to 
a  suffering  world."  According  to  Badcock,^  similar 
experiences  were  met  with  abroad.  Out  of  547,646 
vaccinated,  11.773  "^^t^re  attacked  with  Small  Pox, 
1,294  became  disfigured  or  infirm,  and  1,379  died  in 
consequence  of  the  disease.  Indeed,  in  France, 
vaccination  was  credited  with  having  no  effect  over 
malignant  Small  Pox  ;  while  in  England,  when  a 
less  malignant  variety  attacked  the  vaccinated,  the 
argument  was  used  that  if  it  had  not  been  for 
vaccination    the  attack   might   have  been   worse. 

Even    Ceely,-   one    of  the    most     accurate     obervers. 

'    Vol.  ii.,  p.  51;. 
-  Vol.  ii.,  p.  T^t^. 


PROGRESS   OF   VACCINATION-  IN  ENGLAND. 


451 


who  had  convinced  himself  that  Cow  Pox  arose 
"spontaneously"  in  the  cow,  and  had  never  been 
able  in  all  his  practical  investigations  to  find  any  other 
explanation  for  its  origin,  was  nevertheless  so  in- 
fluenced by  Baron's  teachings,  that  when  he  succeeded 
in  raising  a  vesicle  on  the  cow  by  inoculation  of 
human  variola,  a  vesicle  which  had  the  physical 
characters  of  the  vaccine  vesicle,  he  was  led  to  believe 
that  he  had  succeeded  in  producing  Cow  Pox  bv 
inoculation  of  human  Small  Pox.  Thus,  Baron's 
historical  researches,  and  Ceely's  misinterpreted  in- 
vestigations, were  summed  up  by  Baron  in  the 
words,  "  Vaccination  is  now,  indeed,  placed  upon 
a  rock."  There  was  not  only  no  hesitation  in 
substituting  the  term  Cozu  Small  Pox  for  the  original 
Coiu  Pox.  but  although  outbreaks  of  Cow  Pox 
were  discovered  perfectly  independently  of  any 
human  variola,  Baron's  historical  researches,  Ceely 
and  Badcock's  experiments,  and  the  incidents  related 
by  Waterhouse  and  Bree,  led  to  the  theory  of  Cow 
Small   Pox,  being  regarded  as  an  established  fact. 

In  1857.  vaccination  obtained  further  support  from 
the  Blue  Book  on  vaccination  compiled  by  Simon. 
It  would  be  out  of  place,  here,  to  analyse  that 
report,  but  it  remains  as  evidence  of  the  extra- 
ordinary hold  which  the  Jennerian  doctrine  had  uj^on 
the  minds  of  even  distinguished  sanitarians.  It  is. 
however,   much   to  be  regretted  that   the  teachings  and 


452        PROGRESS  OF   VACCINATION  IN  ENGLAND. 


fallacies  of  Baron  should  have  been  reproduced,  and 
Jenner's  Inquiry  described  as  a  masterpiece  of  medical 
induction — a  similar  comment  to  that  of  Blumenbach 
on   Jenner's  researches  on  the  cuckoo. 

Not  only  were  Baron's  blunders  with  regard  to 
Cattle  Plague  quoted  with  approval,  but  the  Cow 
Small  Pox  theory  again  comes  to  the  front  under 
cover  of  Ceely's   variolation   experiment. 

"  It  was  not  till  forty  years  afterwards  that  science  supplied  an 
authentic  interpretation  of  Jenner's  wonderful  discovery ;  he, 
indeed,  had  suspected  the  solution,  and  had  hinted  his  meaning 
when  he  called  the  Cow  Pox  by  the  name  of  *  Variolae  Vaccinae,' 
for  such  in  fact  it  is — the  Small  Pox  of  the  cow." 

Simon  also  endorses  the  following  statement  to 
show  that  "  a  host  of  theoretical  objections  to  vacci- 
nation might  have  been  met,  or  indeed  anticipated, 
if  it  could  have  been  affirmed  sixty  years  ago,  as  it 
can  be  affirmed  now," 

"  '  This  new  process  of  preventing  Small  Pox  is  really  only 
carrying  people  through  Small  Pox  in  a  modified  form.  The 
vaccinated  are  safe  against  Small  Pox,  because  they,  in  fact,  have 
had  it.  Their  safety  is  of  the  same  sort  as  if  they  had  been 
inoculated  under  the  old  process,  or  had  been  infected  by  the 
natural  disease.  The  trifling  disorder  which  they  suffer,  those 
few  tender  vesicles  on  the  arm,  the  slight  feverishness  which  they 
show,  is  Small  Pox  of  the  most  modified  kind  ;  Small  Pox  so 
modified  by  the  intermediate  animal  organisation  through  which 
it  has  passed,  that  when  thus  reintroduced  into  the  human  body 
it  excites  but  insignificant  disturbance,  and  no  general  exhalation 
of  infected  material.' " 


PROGRESS   OF   VACCAYA  7V0A'  LV  ENGLAND. 


453 


Thus  P>aser's  creed  led  to  a  pathological  error, 
which,  in  turn,  was  officially  commended  on  the  f^n-ound 
that  it  met  a  host  of  theoretical  objections.  The  same 
theory  having  been  officially  accejited,  has  been  repro- 
duced in  our  medical  text-books,  and  the  student  is 
led  to  believe  that  Cow  Pox  arises  from  milkers 
suffering  from  Small  Pox,  and  Cow  Pox  is,  there- 
fore, Small  Pox  modified  by  transmission  through 
the  cow.  But  the  fallacy  of  this  doctrine  is  too 
obvious ;  for  in  the  numerous  outbreaks  in  cows  and 
horses  from  which  "  vaccine  lymph  "  has  been  |jro- 
cured,  if  the  source  of  the  disease  were  Human  Small 
Pox,  there  would  have  been  little  or  no  difficulty  in 
tracing  the  infection.  But  never,  in  any  outbreak  of 
Cow  Pox  or  Horse  Pox,  has  a  connection  with 
Human   Small   Pox  been  established. 

The  reply  may  be  made  to  this,  that  Cow  Pox 
is  so  excessively  rare  a  disease  that  there  have  not 
been  sufficient  opportunities  for  observation  ;  and  that 
further,  the  rarity  of  the  disease  harmonises  with 
the  belief  that  it  arises  from  Human  Small  Pox. 
Such  a  statement  is  in  direct  opposition  to  facts. 
Cow  Pox  and  Horse  Pox  have  been  met  with  and 
studied  arain  and  ao^ain.  If  the.se  diseases  were  de- 
rived  from  Human  Small  Pox,  the  observation  would 
have  been  established  with  as  much  certainty,  as  that 
hydrophobia  in  man  results  frcjm  th(i  bite  of  a 
rabid    dog.      To    emphasize    this    point.    1    will    give    a 


454        PROGRESS   OF   VACCINATION  IN  ENGLAND. 

brief  summary  of  the  outbreaks  of  Cow  Pox  which 
have  occurred  in  this  and   in  other  countries. 

In  England,  Jenner  found  Cow  Pox  in  1770,  1780, 
1782,  1 791,  1794.  1796.  In  1798,  he  raised  his  first 
stock  of  lymph.  In  1799,  Cow  Pox  was  raging  in  the 
dairies  in  London,  and  was  described  by  Woodville, 
Pearson,  and  Bradley.  In  the  same  year,  Cow  Pox 
broke  out  at  Norton  Nibley,  in  Gloucestershire,  and 
lymph  was  taken  for  Jenner's  use.  Later,  a  fresh  stock 
was  raised  from  the  dairies  in  Kentish  Town.  Pearson 
and  Aikin  described  the  prevalence  of  Cow  Pox  in 
Wilts,  Somerset,  Devon,  Buckingham,  Dorset,  Norfolk, 
Suffolk,  Leicester,  and  Stafford  ;  and  Barry  described 
its  prevalence  in   Ireland. 

From  this  time  onwards,  for  a  long  period,  natural 
Cow  Pox  received  little  or  no  attention  in  this  country. 
Fresh  stocks  of  lymph  were  occasionally  raised,  but 
no  further  attention  was  paid  to  the  disease  in  the 
cow. 

In  1836,  Leese  met  with  an  outbreak,  and  raised  a 
stock  of  lymph  which  was  introduced  among  the 
current  stocks.  In  1838,  Estlin  met  with  an  outbreak 
in  Gloucestershire,  and  raised  a  fresh  stock  of  lymph. 
Cow  Pox  was  observed  in  1838-39  by  Mr.  F^ox,  of  Cerne 
Abbas  ;  and  again  in  1839,  in  Dorsetshire,  by  Sweeting, 
of  Abbotsbury  ;  and  in  1838,  1840,  1841,  and  1845, 
tresh  stocks  of  lymph  were  raised  by  Ceely,  Cow  Pox 
being    frequently   met   with    in    the   Vale   of  Aylesbury. 


PROGRESS   OF   VACCINATION  /N  ENGLAND. 


J5S 


From  this  time  onwards,  outbreaks  of  the  disease  in 
the  cow  have  not  been  recorded,  but  several  ])racti- 
tioners  met  with  the  disease,  and  raised  fresh  stocks. 

Thus,  when  inquiries  were  made  in  1857,  it  was 
found  that  several  medical  men  had  employed  fresh 
vaccine  lymph  ;  Mr.  Donald  Dalrymple,  of  Norwich 
(on  two  occasions) ;  Mr.  Beresford,  of  Narborough,  in 
Leicestershire;  Mr.  Gorham,  of  Aldeburofh ;  Mr,  Alison, 
of  Great  Retford  ;  Mr.  Coles,  of  Leckhamjjton  ;  Mr. 
Rudge,  of  Leominster,  and  one  or  two  others.  Mr. 
Sweeting  had  met  with  the  disease  in  two  instances, 
and  had  disseminated  lym])h  obtained  by  the  \accination 
of  persons  from  each  source.  Another  stock  of  lymph 
was  raised  by  Ceely  in  1845,  and  lastly,  in  1887,  I 
investiofated  an  outbreak  of  Cow   Pox  in  Wiltshire. 

In  Italy,  Cow  Po.x  was  found  by  Sacco  in  1800,  in 
the  Plains  of  Lombcirdy,  and  by  other  practitioners  in 
1808-9.  Ii^  1812,  it  was  observed  at  Naples  by 
Miglietta ;  in  1830,  in  Piedmont;  and  in  1832,  and 
1843,  ''^'^  Rome,  by  Dr.  Maceroni.  Quite  recently 
several  outbreaks  of  Cow  Pox  have  been  encountered, 
and  the  stocks  of  lymph  renewed. 

In  France,  in  18 10,  Cow  Pox  was  found  in  the 
Department  of  La  Meurthe,  and  in  1822,  at  Clairvaux  ; 
at  Passy,  Amiens,  and  Rambouillet  in  1836;  at  Rouf-n 
in  1839  ;  at  Saint  Illide,  at  Saint  Seine,  and  at  Perylhac 
in  1841  ;  in  1842.  at  Pagnac  ;  in  1843,  '^^  D-ux 
Jumeaux,    where,     during     the     previous     thirty    years. 


456        PROGRESS   OF   VACCINATION  IK  ENGLAND. 


several  fresh  stocks  of  lymph  had  been  raised  and 
circulated.  Cow  Pox  broke  out  in  a  cow  belonging  to 
M.  Majendie  in  1844  ;  and  it  was  found  at  Wasseloune 
in  the  Department  of  Bas  Rhin  in  1845  ;  it  occurred 
in  three  Departments  in  1846  ;  at  Rheims,  and  in 
the  Department  of  Eure  et  Loire  in  1852  ;  in  the 
arrondissement  of  Sancerre,  and  at  Beziers  in  1854  ; 
and  at  Guyonville  in  1863.  On  farms  in  three 
villages  near  Nogent  in  1864  (the  disease  was 
introduced  by  newly  purchased  cows ;  milkers  were 
infected,  and  from  one  of  these  milkers  a  lymph 
stock  was  established)  ;  in  1864,  also  at  Petit  Ouevilly. 
near  Rouen;  and  in  April  1866,  at  Beaugency ;  in 
1881,  at  Eysines,  near  Bordeaux,  and  again  at  the 
same  place  in    1883  ;  and  in    1884,  ^^  Cerons. 

In  Germany,  as  soon  as  attention  had  been  drawn 
to  the  disease.  Cow  Pox  was  frequently  discovered. 
It  was  also  ascertained  that  it  had  been  referred  to 
in  a  Gottingen  newspaper  published  in  1769.  The 
disease  appears  to  have  been  well  known  there,  and 
milkers  who  contracted  the  disease  by  milking  the 
cows  had  the  same  tradition  as  the  dairymaids  in 
Gloucestershire,  as  to  its  protective  power  against 
Small  Pox.  In  1802,  Cow  Pox  was  met  with,  accord- 
ing to  Bucholz,  in  different  parts  of  Germany  — 
in  Mecklenburor,  Holstein,  Brandenburp;,  Silesia,  and 
the  neighbourhood  of  Gresen  and  Erlangen.  In 
1812,     Cow    Pox     was    discovered     in     Berlin    and    its 


PI^OGRESS   OF   VACCJNA'/70N  JA'  ENG/.AX/).        .y.-j 

suburbs  by  Bremer  ;  near  Luneburg  by  l-ischer  ;  and  in 
Greifswalde  by  Mende;  in  iSi6  at  Seggerde  in  P^runs- 
wick,  by  Giesker  ;  and  in   otlu-r  parts  of  Brunswick. 

In  Holstein,  from  1813  to  1S24.  Luders  met  wiili 
five  epizootics  in  the  farms  of  Biistorf,  Berensbrook, 
Ornum,  Eichthal,  and  Hobi-'stein.  and  also  a  great 
number  of  isolated  cases,  Ritter  found  this  disease 
very  common  in  Schleswig-Holstein.  It  was  found, 
in  1829,  by  Riss,  at  Neu  Busach,  and  by  Albeis,  near 
Stralsund,   in    1834. 

In  W'urtemberg.  betw^een  the  years  1825  to  1837, 
numerous  outbreaks  were  reported.  The  great  number 
in  1829,  corresponds  with  the  publication  of  a 
description    of  Cow   Pox  :— 


1825 

I 

1827 

5 

1828 

3 

1829 

38 

1830 

31 

1 83 1 

31 

1832 

18 

1833 

14 

1834  • 

18 

1835 

19 

1836 

2.S 

1837 

18 

In  sixty-nine  places  the  vaccinogenic  property  of 
the  lymph,  from  eighty-four  cows,  was  established  by 
inoculation.  One  hundred  and  twenty-six  children,  and 
a  girl  twenty-two  years  old,  were  vaccinated  with 
success,    and    the    stocks    of  lymph    were    circulated    in 


458        PROGRESS   OF   VACCINATION  IN  ENGLAND. 

Other  countries.  After  1830,  fresh  lymph  was  sent  to 
the  vaccine  institutions  at  Stuttgart,  and  employed 
successfully  ;  so  that  in  ten  years  many  hundreds  of 
children  were  vaccinated  with  Cow  Pox  lymph  collected 
in   Wurtemberg. 

In  Holland,  according  to  Numann,  Cow  Pox  was 
found   in    1805,    in    181 1,   and    in    1824. 

In  Denmark,  it  was  found  by  Niergaard,  at  Fiinen, 
in    1801. 

In  Russia,  in  1838,  an  epizootic  occurred  among 
the  cows  in  a  village  in  the  neighbourhood  of  St. 
Petersburg. 

In  North  America  it  was  found  by  Dr.  Buett,  of 
Massachusetts,  and  by  Drs.  Norton  and  Trowbridge, 
of  Connecticut,  in    1801. 

In  South  America  it  was  found  in  the  valley  of 
Ablixco,  in  the  neighbourhood  of  Valladolid  de 
Mechoacan,  and  in  the  district  of  Calabozo,  in  the 
province  of  Caraccas  ;  and  by  Humboldt  in  Peru,  and 
was  known,  according  to  Pepping,  among  the  cows 
in   Chili. 

Hence  it  is  evident  that  natural  Cow  Pox  is  far 
from  being  a  rare  disease,  as  many  have  supposed, 
who  are  unacquainted  with  the  subject ;  and,  further, 
in  not  one  of  these  numerous  outbreaks  has  any  causal 
relationship  with    Human   Small   Pox  been  established. 

To  assert,  therefore,  the  theory  of  Cow  Small  Pox 
on  the   ground   of   Ceely  and    Badcock's   experience,   is 


PROGRESS   OF   VACCINAT/OX  IX  EXGLAXf).        459 


to  substitute  experimental  fallacies  for  cornxn  clinical 
observation.  I  must  again  assert  that  there  is  no 
proof  whatever  that  i/ic  disease.  Cow  Pox.  was  pro- 
duced by  the  inoculation  of  cows  with  Human  Small 
Pox.  After  a  number  of  trials  a  vesicle  was  produced 
possessing  the  physical  characters  of  inoculated  Cow 
Pox  ;  but,  inasmuch  as  cattle  plague,  when  inoculated, 
produces  a  vesicle  with  the  physical  characters  of 
Cow  Pox,  that  Sheep  Pox  and  Horse  Pox  can  also 
be  so  cultivated  as  to  produce  similar  appearances, 
there  is  no  more  reason  for  supposing  that  Human 
Small  Pox  was  transformed  into  Cow  Pox,  than  there 
is  for  believing  that  Cow  Pox,  Horse  Pox,  Human 
Small  Pox,  Cattle  Plague,  and  Sheep  Pox  are  all 
manifestations   of  one  and  the   same   disease. 

The  practical  student  of  Cow  Pox  is  at  once  con- 
vinced, without  any  further  evidence,  that  the  two 
diseases,  Small  Pox  and  Cow  Pox,  are  specifically 
distinct.  Cow  Pox  is  a  disease  communicable  solely 
by  contact.  Small  Pox  is  a  disease  which,  though 
inoculable,  is  also  highly  infectious.  Cow  Pox  begins 
as  a  local  affection,  and  is  followed  by  constitutional 
symptoms.  Small  Pox  is  an  acute  disease,  characterised 
by  sudden  and  severe  fever,  which  is  followed  after 
forty-eight   hours  by  a   generalised  eruption. 

If  we  study  inoculated  Cow  Pox  in  early  removes 
from  the  cow,  we  observe  the  formation  of  a  papule, 
a     vesicle,     an     ulcer     with      surrounding      induration, 


46o         PROGRhSS^OF    VACCINATION  IN  ENGLAND. 

enlargement  of  the  lymphatic  glands,  and  secondary^ 
eruptions  or  vaccinides.  Cow  Pox.  in  fact,  as  Auzias- 
Turenne  ^  pointed  out  in  1865,  is  strictly  analogous 
to  syphilis,  and  it  is  only  by  a  comparison  with  this 
disease  that  we  can  really  follow  its  natural  history. 
In  most  of  our  medical  text-books,  the  description 
of  Cow  Pox  is  not  the  description  of  the  natural 
disease  ;  it  is  simply  an  account  of  the  appearances 
which  result  after  it  has  been  artificially  cultivated  on 
the  arm  of  a  child  or  the  belly  of  a  calf.  The 
ordinary  description  of  vaccinia  stands  in  the  same 
relation  to  the  disease  Cow  Pox  as  a  description  of 
the  benign  vesicle  of  variolation  to  the  full  cycle  of 
the  natural  Small  Pox.  It  is  only  when  we  have 
to  deal  with  the  early  removes  from  the  cow,  or 
when  the  lymph  reverts  to  its  original  untamed 
character,  that  we  really  appreciate  what  the  symptoms 
of  Cow  Pox  are.  Jenner  has  given  many  instances, 
which  stand  in  striking  contrast  to  the  mitigated 
aftection  described  as  "tender  vesicles  with  slight 
feverishness."  We  know  that  Jenner  met  with  what, 
at  the  present  day,  are  called  vaccinal  accidents  ; 
these  are  manifestations  of  the  disease  in  its  unmiti- 
gated form  ;  it  is  then  associated  with  violent 
constitutional  symptoms,  the  development  of  corroding 
ulcers,   and  generalised  eruptions.      Bousquet  met    with 

'  Vol.  ii.,  p.  552. 


i'LATK    XXH. 


o 

04 


o 
o 

o 

•J 
o 

H 

00 

O 

o; 


^uum:jU&%/.Q-.M. 


PROGRESS   Of   VACCI.VA770y  /X  RXGLAXD.         ,<,, 

similar  experiences.  Estlin  has  fully  ilescriijed  the 
results  which  followed  from  the;  user  of  lymph  recently 
derived  from  the  cow.  and  Ceely  also  met  with 
similar    accidents. 

In  speaking  of  Small  Pox  inoculation.  I  have  referred 
to  the  differences  which  resulted  from  taking  lymph 
at  different  periods;  and  there  can  he  no  (lue-stirtn 
that  the  same  laws  which  a])ply  to  .Small  Pox  inocu- 
lation, apply  also  to  Cow  Pox  inoculation.  Cow  Vox 
lymph  taken  at  a  late  stage  will  tend  on  some  sub- 
jects to  revert  to  its  original  virulency.  or,  as  P)Ou.squet 
calls  it.  saiLvagerie,  just  as  .Small  Pox  lymjjh  tak(;n 
at  a  late  period  and  ingrafted  on  a  suitable  soil  may 
induce,  not  a  transient  j^apule  or  a  benign  vesicle, 
but  an   attack  of  continent   .Small    Pox. 

1  have  already  stated  that  Auzias  Turenne  was  the 
first  to  i)oint  out  that  Cow  Pox  is  analogous  to 
syphilis;  but  even  the  earliest  opponents  of  vaccination 
regarded  the  disease  as  lues  Iwvilla,  and  it  had  e\cn 
been  suggested  that  the  cow  had  derived  the  com- 
plaint from  milkers  who  were  affected  with  syphilis. 
There  is  no  more  ground  for  believing  in  the  latit-r 
theory  than  there  is  for  believing  that  Cow  Pox  is 
produced  by  milkers  suffering  from  .Small  Pox.  It  is 
the  course  which  the  malady  runs  which  brings  it  so 
closely  into  relation  with  syi)hilis  ;  and  1  find  that  in 
Horse  Pox,  the  parallel  is  still  closer,  inasmuch  as 
Horse   Pox  is  transmitted  by   coition.      In   this  country. 


462        PROGRESS   OF   VACCINATION  IN  ENGLAND. 


Creighton  ^  has  pointed  out  how  closely  the  inocu- 
lated syphilis  runs  parallel  with  the  natural  Cow  Pox; 
so  much  so  that  he  has  a  tendency  to  regard  all 
cases  of  so-called  vaccinal  syphilis  as  truly  vaccinal, 
being  reversions  to  the  original  type  of  the  disease 
in  the  cow.  This  may  be  too  sweeping  an  asser- 
tion, for  there  appears  to  be  very  little  doubt  that 
syphilis  may  be  transmitted  by  vaccination  ;  but 
many  cases  which  are  attributed  to  syphilis  are  un- 
questionably the  full  effects  of  the  Cow  Pox  virus  ; 
and  nothing  could  more  clearly  point  to  the  analogy 
between  the  two  diseases  than  the  difficulty  in  dia- 
gnosing the  exact  nature  of  these   vaccinal  accidents. 

Again,  if  we  study  the  effects  o{  syphilis  artificially 
inoculated  on  the  human  subject,  the  appearances  in 
some  cases  are  strikingly  similar  to  inoculated  Horse 
Pox.  Without  entering  into  a  prolonged  discussion 
of  this  subject,  I  will  refer,  as  an  example,  to  the 
progress  in  Ricord's  cases  of  syphilisation.  As  in 
inoculated  Horse  Pox  we  have  the  stages  of  papule, 
vesicle,  ulcer,  scab,  and  scar  ;  and  no  one  can  compare 
his  plates  with  Jenner's  (see  Plates  IV.  and  XXIH.) 
without  being  struck  with  the  similiarity  in  their 
appearances.  The  results  of  the  artificial  inoculation 
of  syphilis  were  unknown  to  jenner,  but  it  they 
had  been  he  would  scarce!)-  have  failed  to  have 
observed     the     likeness     between     them.       So    striking 


Creiijhton.     Cozv  Pox  avd  Vaccinal  Syf  hilts. 


Pl^l. 


■tf;^^n>L 


Pltf  ?.. 


Facing  f^ge   ^t,- 
PI.ATK   XXIII. 


f 


Fi^S. 


Figs. 


o 


?i 


V 


Tig4. 


Ti^7 


R^5 


INOCULATED     SYPHILIS     (lUCOKD) 
Compare  Fig.  «j  with  Plate  IV. 


TuiaiitimjMS^AJinJtt 


PROGRESS   OF   VACCINATION  IN  ENGLAND.        463 


indeed  are  the  appearances,  that  it  is  possible  that, 
by  judicious  selection,  a  strain  of  s\philitic  lymph 
niio^ht  be  cultivated  which  would  produce  in  time  all 
the    physical    characters    of  the    "  vaccine  "    vesicle. 

As  the  result  of  an  investigation  into  the  history, 
and  especially  the  pathology,  of  "  vaccination,"  1  feel 
convinced  that  the  profession  has  been  misled  by 
Jenner,  Baron,  the  Reports  of  the  National  \^iccine 
Establishment,  and  by  a  want  of  knowledge  concerning 
the  nature  of  Cow  Pox,  Horse  Pox,  and  other  sources 
of  "  vaccine  lymph."  Though  in  this  country,  vaccine 
lymph  is  generally  taken  to  mean  the  \irus  of  Cow 
Pox,  yet  the  pathology  of  this  disease,  and  its 
nature  and  affinities,  have  not  been  made  the  subject 
of  practical  study  for  nearly  half  a  century.  We  have 
sul)mitted  instead  to  purely  theoretical  teaching,  and 
have  been  led  to  regard  vacciiiation  as  inoculation  of 
the  human  subject  with  the  virus  of  a  benign  disease 
of  the  coiu,  whereas  the  viruses  in  use  have  been 
derived  from  several  distinct  and  severe  diseases  in 
different    animals. 

The  statement  that  the  protective  measures  which 
have  been  introduced  by  Pasteur,  such  as  inoculation 
for  chicken  cholera,  anthrax,  and  rabies,  are  analogous 
to  Jenner's  \accination  as  a  }jrotective  against  Small 
Pox,  is  the  most  recent  extension  of  the  fallacious 
theory  of  Cow  Small  Pox.  Pasteur's  system  is  the 
same     in      principle     as     the     old      method      ot      Small 


464        PROGRESS  OF   VACCINATION  IN  ENGLAND. 


Pox  inoculation.  Variolation,  though  a  dangerous 
practice,  can  at  least  claim  to  be  based  upon  scientific 
grounds,  viz.,  the  prevention  or  modification  of  a  disease 
by  artificially  inducing  a  mild  attack  of  that  disease. 
Jenner's  substitution  of  Cow  Pox  inoculation  was  a 
purely  empirical  treatment  based  upon  folklore,  and 
involved  a  totally  different  pathological  principle — the 
protection  from  one  disease  by  the  artificial  induction 
of  a  totally  distinct  disease — a  principle  which  was 
not.  and  has  not  been  since,  supported  by  either 
clinical  experience  or  pathological  experiments.  The 
Jennerian  method  has  for  nearly  a  century  struggled 
for  existence  with  the  support  of  the  Cow  Small 
Pox  theory  and  the  numerous  and  ingenious  explana- 
tions of  failures  embodied  in  the  assertions  of 
spurious  Cow  Pox,  inefficiently  performed  vaccination, 
inferior  quality  of  lymph,  deficiency  in  the  number  anci 
quality  of  marks  ;  and  the  misinterpretation  of  statistics.^ 
Inoculation  of  Cow  Pox  does  not  have  the  least 
effect  in  affording  immunity  from  the  analogous 
■disease  in  man,  syphilis,  and  neither  do  Cow  Pox, 
Horse  Pox,  Sheep  Pox,  Cattle  Plague,  or  any  other 
radically  dissimilar  disease,  exercise  any  specific  pro- 
tective power  against  Human  Small  Pox.  Inoculation 
of  Cow  Pox,  Horse  Pox,  and  Cattle  Plague  have 
totally  failed  to  exterminate  Small  Pox  ;  and  for  the 
eradication    of    this    disease    we    must    in     future    resort 

'    I'ide  p.  163. 


PRO GI^ ESS   OF   VACCINATION  IN  ENGLAND.        465' 


to  methods  similar  to  those  proposed  by  Hay^arth, 
which  in  modern  times  have  been  so  successful  in 
STAMPING  OUT  diseases  of  the  lower  animals,  such 
as  Cattle  Plaj^ue,  Foot  and  Mouth  Disease,  and 
Sheep    Pox. 

In  the  case  of  the  lower  animals  this  has  been 
effectually  performed  by  notification,  combined  with 
either  slaughter,  isolation,  or  muzzling.  It  has  been 
stated  that  rabies  might  be  stamped  out  of  this 
country  in  twelve  months  by  universal  muzzling  ;  with 
equal  truth  may  it  be  said  that  Small  Pox  might  be 
stamped  out  in  the  same  time  by  notification  and  a 
rigid  system  of  isolation.  And  if  any  practical  benefit 
is  to  be  derived  from  Pasteur's  system  of  protective 
inoculation,  I  cannot  see  any  scientific  reason  why 
nurses  and  other  attendants  upon  cases  of  Small  Pox, 
should  not  be  protected  by  inoculation  with  attenuated 
Small  Pox  within  the  walls  of  a  Small  Pox  hospital, 
and  with  due  precaution  to  prevent  the  spread  of 
infection. 

There  can  be  no  doubt  that  ere  long  a  system 
of  COMPULSORY  NOTIFICATION  and  ISOLATION  will  re- 
place vaccination.  Indeed,  I  maintain  that  where 
isolation  and  vaccination  have  been  carried  out  in 
the  face  of  an  epidemic,  it  is  isolation  which  has 
been  instrumental  in  staying  the  outbreak,  thc^ugh 
vaccination    has    received  the   credit. 

Unfortunately   a   belief  in  the   efficacy  of  vaccination 
VOL.  I.  30 


466        PROGRESS   OF   VACCIATATION  IN  ENGLAND. 

has  been  so  enforced  in  the  education  of  the  medical 
practitioner,  that  it  is  hardly  probable  that  the  futility 
of  the  practice  will  be  generally  acknowledged  in 
our  generation,  though  nothing  would  more  redound 
to  the  credit  of  the  profession  and  give  evidence  of 
the  advance  made  in  pathology  and  sanitary  science. 
It  is  more  probable  that  when,  by  means  of  notification 
and  isolation.  Small  Pox  is  kept  under  control, 
vaccination  will  disappear  from  practice,  and  will  retain 
only  an  historical  interest. 


FINIS. 


^JL 


^ 


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